儿童、青少年和青年（CTYA，0-24 岁）癌症非常罕见且多样化，因此及时诊断具有挑战性。我们的目标是探索与随后的癌症诊断相关的症状和症状组合，并确定其时间表。使用 QResearch 数据库，我们进行了匹配的巢式病例对照研究。使用条件逻辑回归探讨了初级保健中遇到的预先指定的症状与任何癌症的后续诊断之间的关联。中位诊断间隔用于将症状分为“晚期”和“早期”时间范围，以识别相关的早期症状。从 3,424,771 名 CTYA 队列中识别出 3186 例病例和 50,576 名对照。我们发现了 12 个新的关联，其中偏瘫 [OR 90.9 (95%CI 24.7-335.1)，PPV = 1.6%]、睾丸肿胀 [OR 186.7 (95%CI 86.1-404.8)，PPV = 2.4%] 和器官肿大 [OR 221.6（95%CI 28.3-1735.9），PPV = 5.4%]具有显着的阳性预测值（PPV）。肢体疼痛是儿童严重疾病的已知标志，是癌症亚型中反复出现的早期症状。在儿童癌症和 TYA 癌症中观察到类似的临床表现。利用迄今为止最大的队列，我们​​提供了有关症状在 CTYA 癌症诊断中随时间变化的预测效用的新信息。我们的研究结果将有助于提高临床和公众对症状的认识，对高风险人群进行分层，并最终帮助早期诊断。© 2024。作者。

Childhood, teenage and young adult (CTYA, 0-24 years) cancers are rare and diverse, making timely diagnosis challenging. We aim to explore symptoms and symptom combinations associated with a subsequent cancer diagnosis and to establish their timeframe.Using the QResearch Database, we carried out a matched nested case-control study. Associations between pre-specified symptoms encountered in primary care and a subsequent diagnosis of any cancer were explored using conditional logistic regression. Median diagnostic intervals were used to split symptoms into "late" and "early" timeframes to identify relevant early symptoms.3186 cases and 50,576 controls were identified from a cohort of 3,424,771 CTYA. We identified 12 novel associations, of which hemiparesis [OR 90.9 (95%CI 24.7-335.1), PPV = 1.6%], testicular swelling [OR 186.7 (95%CI 86.1-404.8), PPV = 2.4%] and organomegaly [OR 221.6 (95%CI 28.3-1735.9), PPV = 5.4%] had significant positive predictive values (PPV). Limb pain, a known marker of serious illness in children, was a recurrent early symptom across cancer subtypes. Similar clinical presentations were observed across childhood and TYA cancers.Using the largest cohort to date, we provide novel information on the time-varying predictive utility of symptoms in the diagnosis of CTYA cancers. Our findings will help to raise clinical and public awareness of symptoms, stratify those at higher-risk and ultimately aid earlier diagnosis.© 2024. The Author(s).