Terms used in this guideline
This section defines terms that have been used in a particular way for this guideline.
Children
From birth to 15 years.
Children and young people
From birth to 24 years.
Consistent with
The finding has characteristics that could be caused by many things, including cancer.
Direct access
When a test is done and primary care retain clinical responsibility throughout, including acting on the result.
Hormone replacement therapy (HRT)
HRT in this guideline includes combined oestrogen and progestogen HRT including sequential combined HRT, continuous combined HRT and any combination of the 2; and oestrogen-only HRT.
Immediate
An acute admission or referral occurring within a few hours, or even more quickly if necessary.
Non‑urgent
The timescale generally used for a referral or investigation that is not considered very urgent or urgent.
Non-specific symptoms pathway
Non-specific symptoms pathways are designed for people whose symptoms do not clearly fit into a suspected cancer referral pathway as defined by this guideline. Symptoms considered 'non-specific' include unexplained weight loss, fatigue, abdominal pain, nausea, or a GP's 'gut feeling' about cancer. This pathway should apply when symptoms are suggestive of cancer but do not clearly meet tumour-specific suspected cancer pathway referral criteria.
Persistent
The continuation of specified symptoms and/or signs beyond a period that would normally be associated with self‑limiting problems. The precise period will vary depending on the severity of symptoms and associated features, as assessed by the health professional.
Raises the suspicion of
A mass or lesion that has an appearance or a feel that makes the healthcare professional believe cancer is a significant possibility.
Safety netting
The active monitoring in primary care of people who have presented with symptoms. It has 2 separate aspects:
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timely review and action after investigations
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active monitoring of symptoms in people at low risk (but not no risk) of having cancer to see if their risk of cancer changes.
Suspected cancer pathway referral
Person to receive a diagnosis or ruling out of cancer within 28 days of being referred urgently by their GP for suspected cancer. For further details, see NHS England's webpage on operational management, administration and performance – faster diagnosis framework.
Unexplained
Symptoms or signs that have not led to a diagnosis being made by the healthcare professional in primary care after initial assessment (including history, examination and any primary care investigations).
Unexplained post‑menopausal bleeding
Vaginal bleeding that cannot be attributed to HRT timing, expected settling-in timing, or any identified benign cause, and therefore requires further assessment to exclude underlying pathology.
Unscheduled vaginal bleeding on HRT
Vaginal bleeding that occurs after starting or changing an HRT regimen that is expected to be bleed-free (continuous combined HRT), or bleeding that occurs in addition to the planned withdrawal bleed (sequential HRT). It can occur within the first 6 months of starting HRT, or within 3 months of changing a dose or preparation.
Urgent
To happen or be done before 2 weeks.
Very urgent
To happen within 48 hours.
Young people
Aged 16 to 24 years.