Which option is NOT a red flag for cancer in back pain?

• A. Over 50 years old
• B. Unexplained weight loss
• C. Prior history of cancer
• D. Fever

Answer: (D)

The key idea is differentiating red flags that suggest cancer from those that point to other serious causes. Cancer-related back pain is typically flagged by age over 50, unexplained weight loss, and a prior history of cancer, all of which raise suspicion for malignancy or metastatic disease. Fever, while important in evaluating back pain, more strongly signals infection (such as discitis or osteomyelitis) rather than cancer. So fever by itself isn’t a cancer-specific red flag. If fever is present, you should evaluate for infectious processes, but it does not inherently indicate cancer as the underlying cause.