Cancer: Likelihood Ratios

Introduction: Malignant neoplasm is often on the differential diagnosis of patient presentations, especially patients with so-called "B symptoms" such as fevers or weight loss.

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Patients admitted to Internal Medicine	4%	Rom J Intern Med. 1999 Jul-Sep;37(3):261-7. PMID: 15532304
Patients with involuntary weight loss	31%	(24%) Eur J Intern Med. 2006 Jan;17(1):28-31. PMID: 16378882 (38%) Am J Med. 2003 Jun 1;114(8):631-7. PMID: 12798450
500	4%
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The likelihood ratios of findings for Cancer are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] Elevated ESR	+ 0 -	4.7	0.5
>=50mm/hr. in unselected patients admitted to the hospital Study: Rom J Intern Med. 1999 Jul-Sep;37(3):261-7. PMID: 15532304

Good Negative Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Panel of Blood Tests	+ 0 -	1.5	0.1
Any of: abnormal CBC, Albumin < 3.5, abnormal LFTs, LDH > 500 in patients with unexplained involuntary weight loss. The conclusions is that a panel of blood tests will discover virtually all cancers in these patients. Study: Am J Med. 2003 Jun 1;114(8):631-7 PMID: 12798450

Good Positive Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Weight loss	+ 0 -	7.7	0.6
in unselected patients admitted to the hospital Study: Rom J Intern Med. 1999 Jul-Sep;37(3):261-7. PMID: 15532304