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'Referral advice' recommendation details

Recommendation details

Referral advice recommendation:General Practitioners (GP) should carefully establish whether the patient's signs or symptoms fulfil the criteria for urgent referral for suspected colorectal cancer, and act accordingly. Colonoscopy (or flexible sigmoidoscopy plus barium enema, if patients find colonoscopy unacceptable) should be used when symptoms suggest possible cancer of the right or transverse colon. Patients with iron-deficiency anaemia (apart from menstruating women) should be referred for colonoscopy. People over the age of 50 with rectal bleeding of recent onset or other suspicious symptoms should have rectal examination and flexible sigmoidoscopy or colonoscopy; their symptoms should not be attributed to haemorrhoids until the possibility of colorectal cancer or adenomatous polyps has been excluded. General Practitioners (GPs) should be alert to the possibility that colorectal cancer can co-exist with haemorrhoids. It is important that investigations for bowel symptoms or anaemia should continue until the cause is found. The threshold for referral for investigation should be reduced if other members of the patient's family have had a diagnosis of colorectal cancer. General Practitioners (GPs) should not refer patients with suspected colorectal cancer to a specific clinician (as opposed to a diagnostic clinic) who is not a core member of a colorectal cancer multi-disciplinary team.
Recommendation ID:212
Referral advice category:Urgent

Source guidance details

Guidance ID:CSGCC
Guidance: Colorectal
Issue date:June 2004
Paragraph number:0
Page number:30

NICE Classifications

Topic:
  • Digestive system
  • Cancer
Sub topic:
  • Medical oncology

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This page was last updated: 22 August 2012

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.