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'Referral advice' recommendation details

Colorectal

Guidance ID NICE 'referral advice' recommendation 'Referral advice' category
CSGCC 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. Urgent
CSGCC All patients with symptoms that could be due to colorectal cancer, particularly rectal bleeding or a recently-established change to looser and/or more frequent motions, should have rapid access to colonoscopy or flexible sigmoidoscopy and any further procedures that may be necessary to reach a diagnosis Time frame not specified

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.