Symptoms (GP records) | |
Appetite and upper gastrointestinal symptoms | Change in taste, loss of taste, dry mouth/thirst, dysphagia, loss of appetite or feeling full after eating small amounts, heartburn/gastro-oesophageal reflux (GOR), indigestion, nausea, vomiting, hematemesis, stomach pain/discomfort/cramp |
Abdominal and bowel symptoms | Abdominal pain (right upper quadrant), abdominal lump on the right side, abdominal distension, abdominal mass, swollen abdomen/flatulence/bloating, ascites, change in bowel habits, diarrhoea, constipation, melaena |
Non-specific and systemic symptoms | Weight loss, fatigue/tiredness/lethargy (lack of energy), nausea, confusion (may suggest hepatic encephalopathy), fever, shivering, jaundice (yellow skin), pruritis (itchy skin), rash, dark urine, pale stools, night sweats, right shoulder pain, back pain, peripheral oedema, unexplained bruising |
Comorbidities (GP and HES records) | |
Liver diseases | Cirrhosis, hepatitis B infection, hepatitis C infection, non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease, autoimmune hepatitis, liver adenoma, any other chronic liver diseases |
Cardiorespiratory diseases | Hypertension, coronary heart disease, heart failure, chronic obstructive pulmonary disease (COPD), venous thromboembolism |
Metabolic disorders | Type 1 and type 2 diabetes mellitus, electrolyte disorders, dyslipidaemia, obesity, gout |
Other GI and systemic diseases | Chronic pancreatitis, hepatic cyst, renal cyst, pancreatic cyst, hemochromatosis, cholangitis, gallbladder stones, gastrointestinal haemorrhage, peptic ulcer disease, anaemia, thrombocytopenia |
Others | Heroin use or other drug addiction, alcoholism, HIV/AIDS |
Clinical and family history (GP records) | |
Family history | Liver cancer, (any) gastrointestinal cancers (gastric, bowel, liver, pancreas) |
Personal history | Previous cancers |
Investigation and patient management (logged) in primary care records | |
Blood tests | Haemoglobin, HBV (antibody/antigen/DNA), ALT, AST, PLT, BR, GGT, ESR, CRP |
Medications | Furosemide, spironolactone, propranolol, carvedilol, lactulose, rifaximin, tenofovir, entecavir, lamivudine, antiretroviral therapy; statins, aspirin and metformin |