Guidance
Update information
October 2023: We updated the definition of suspected cancer pathway referral in line with NHS England's standard on faster diagnosis of cancer.
August 2023: We updated the recommendations on criteria for faecal testing and referral for suspected colorectal cancer in line with NICE's diagnostics guidance on quantitative faecal immunochemical testing to guide colorectal cancer pathway referral in primary care. The tables of symptoms and primary care investigation findings have been updated to reflect these changes. New and amended recommendations are marked [2023] or [2015 amended 2023].
December 2021: We reviewed the evidence on fixed and age-adjusted thresholds for PSA testing and updated recommendation 1.6.3.
January 2021: We amended the recommendations in the section on colorectal cancer to include the full list of criteria for faecal testing.
September 2020: We amended the recommendations in the section on colorectal cancer to clarify when to offer faecal testing for colorectal cancer to adults without rectal bleeding.
July 2017: Recommendation 1.3.4 was replaced by NICE diagnostics guidance on quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care and other recommendations were amended accordingly. In December 2017, some of the wording in the section on colorectal cancer was clarified, and the tables on abdominal and pelvic pain, change in bowel habit and primary care investigations updated in line with this.
June 2016: Recommendations in the section on colorectal cancer have been changed to say 'adults' instead of 'people' to more accurately reflect the populations they cover.
June 2015: This guideline updates and replaces NICE guideline CG27 (published June 2005).
Recommendations are marked as [2021], [2020], [2015], [2011], [2011, amended 2020] or [2005]:
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[2021] indicated that the evidence has been reviewed and the recommendation has been updated in 2021.
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[2020] indicates that the evidence has been reviewed and the recommendation has been added or updated in 2020.
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[2011, amended 2020] indicates that the wording has been changed but the evidence has not been reviewed since 2020.
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[2015], [2005] or [2011] indicates the date that the evidence was last reviewed.
Minor changes since publication
March 2024: In recommendation 1.12.2 and the table on symptoms in children and young people, we changed absent red reflex to absent fundal ('red') reflex. See the surveillance report for more information.
October 2021: In recommendation 1.12.2 we added a cross-reference to NICE's guideline on suspected neurological conditions for advice for children who have new-onset squint with an absent fundal 'red' reflex. See the surveillance report for more information. We also added a link to NICE's guideline on babies, children and young people's experience of healthcare in the sections on childhood cancers and symptoms in children and young people.
ISBN: 978-1-4731-5438-4