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'Referral advice' recommendation details

Referral for suspected cancer

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Guidance ID NICE 'referral advice' recommendation 'Referral advice' category
CG27 In suspected upper gastrointestinal cancer, an urgent referral should be made for patients presenting with either: unexplained upper abdominal pain and weight loss, with or without back pain, or an upper abdominal mass without dyspepsia. Urgent
CG27 In suspected lung cancer, immediate referral should be considered if there are signs of superior vena caval obstruction (swelling of the face and/or neck with fixed elevation of jugular venous pressure) or stridor. High risk patients (current or ex smokers, a previous history of cancer, previous asbestos exposure or a smoking related lung disease) should be given an urgent referral for a chest X-ray or referral to a specialist team. These criteria are the same as for other patients but referral may be considered sooner, for example if symptoms or signs have lasted for less than 3 weeks. Immediate
CG27 With regards to investigation and referral of patients with suspected lower gastrointestinal cancers: In patients with equivocal symptoms, a full blood count may help in identifying the possibility of colorectal cancer by demonstrating iron deficiency anaemia, which should then determine if a referral should be made and its urgency. In patients for whom the decision to refer has been made, a full blood count may assist specialist assessment in the outpatient clinic. This should be in accordance with local arrangements. In patients for whom the decision to refer has been made, no examinations or investigations other than abdominal and rectal examination and full blood count are recommended as this may delay referral. 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.