STEP 1: Prevention and early detection

Not smoking, limiting sun exposure, eating a healthy diet, avoiding or limiting alcohol intake, taking regular exercise, maintaining a healthy body weight and avoiding exposure to oncoviruses or carcinogenic insults may help reduce cancer risk generally.

This step outlines recommendations for the prevention and early detection of CUP.

The causes of CUP are not fully understood, and there is currently no clear prevention strategy. However, general advice about ways to reduce cancer risk should be advised. Consideration should also be given to identifying individuals carrying a deleterious mutation conferring increased genetic risk. In some cases, CUP may be a manifestation of an undiagnosed hereditary cancer syndrome, with implications for the patient and their family. Patients with CUP with a significant family history of multiple cancers may suggest a heritable mutation within the family such as Lynch syndrome or a germline P53 or BRCA mutation. These patients should be referred to a familial cancer centre for further assessment.

As the primary cancer site is not known for people with CUP, it is difficult to identify risk factors. Evaluating risk is also challenging because of non-uniformity between CUP cases. CUP and advanced cancer research indicates the following factors may increase a person’s risk of developing CUP (AIHW 2018, Brewster et al. 2014, Kaaks et al. 2014, Luke et al. 2008, Urban et al. 2013):

  • increasing age
  • male gender
  • family history of cancer
  • smoking
  • excessive alcohol consumption
  • excess body fat
  • inadequate physical activity
  • living in areas of lower socioeconomic status
  • Aboriginal and Torres Strait Islander background
  • infrequent general practice consultations.

There is no population-based specific screening program for CUP.