Use this consulting line to consult references. If you are still unsure whether a referral is necessary, contact a specialist (see recommendations on the diagnostic approach). Consider testing for others with symptoms related to an increased risk of cancer who don’t meet the benchmark. or research criteria (see safety net recommendations).
have chest X-ray effects that suggest lung cancer, or
are years of age or older and have unexplained hemoptysis. [2015]
cough
fatigue
shortness of breath
chest pain
weight loss
loss of appetite. [2015]
Forceful fingers
Supraclavicular lymphadenopathy or cervical lymphadenopathy.
breast compatible with lung cancer
Thrombocytosis. [2015]
have at least 2 of the following unexplained symptoms, or
have one or more of the following unexplained symptoms and have smoked before, or
Have one or more of the following unexplained symptoms and have been exposed to asbestos:
cough
fatigue
shortness of breath
chest pain
weight loss
loss of appetite. [2015]
blunt hands or
chest compatible with pleural disease. [2015]
with dysphagia or
55 years of age and older with weight loss and any of the following:
upper pain
reflux
dyspepsia. [2015]
treatment-resistant dyspepsia or
upper abdomen with low hemoglobin or
increased platelets with any of the following:
nausea
vomit
weight loss
reflux
dyspepsia
upper pain, or
nausea or vomiting with any of the following:
weight loss
reflux
dyspepsia
upper pain. [2015]
diarrhoea
back pain
abdominal pain
nausea
vomit
constipation
Onset diabetes. [2015]
with dysphagia or
55 years of age and older with weight loss and any of the following:
upper pain
reflux
dyspepsia. [2015]
treatment-resistant dyspepsia or
upper abdomen with low hemoglobin or
increased platelets with any of the following:
nausea
vomit
weight loss
reflux
dyspepsia
upper pain, or
nausea or vomiting with any of the following:
weight loss
reflux
dyspepsia
upper pain. [2015]
Recommendations 1. 3. 1 to 1. 3. 4 are adapted from the NICE diagnostic consultant lines on quantitative faecal immunochemical testing for referral of colorectal cancer consultants to number one care.
with a mass, or
with bowel habits, or
with iron deficiency anemia, or
40 years of age or older with unexplained weight loss and pain, or
younger than 50 with rectal bleeding and any of the following unexplained symptoms:
abdominal pain
weight loss, or
50 years of age or older with any of the following unexplained symptoms:
rectal bleeding
abdominal pain
weight loss, or
People 60 years and older who suffer from anemia even in the absence of iron deficiency. FIT will be presented even if the user has already had a negative FIT result as a component of the NHS bowel cancer screening programme. People with rectal mass, unexplained mass, or unexplained mass ulceration do not want to have an FIT before contemplating a shunt. [2023]
Safety net processes will have to be in place.
Referral to an appropriate secondary care pathway should not be delayed if there is a strong clinical fear of cancer due to persistent and unexplained symptoms (e. g. , abdominal mass). [2023]
30 years of age or older and you have an unexplained breast mass with pain or
50 years of age and older with any of the following on an unmarried nipple:
download
retraction
Other adjustments of interest. [2015]
with skin adjustments that suggest breast cancer or
30 years or older with an unexplained lump in the armpit. [2015]
The recommendations from this segment have been incorporated into the NICE rules on ovarian cancer and updated. Recommendations for ovarian cancer apply to women 18 years and older.
persistent bloating (women call it “bloating”)
feeling of fullness (early satiety) and/or loss of appetite
pelvic or pain
increased urgency and/or urinary frequency. [2011]
Evaluate you for other clinical reasons of your symptoms and investigate if necessary.
If there is no other obvious clinical cause, advise them to see their GP again if their symptoms are more common and/or persistent. [2011]
unexplained vaginal discharge that:
are experiencing those symptoms for the first time, or
have thrombocytosis or
report hematuria, or
visible hematuria and:
low hemoglobin or
thrombocytosis, or
high blood sugar. [2015]
any symptoms of decreased urinary tract, such as nocturia, urinary frequency, hesitation, urgency, or retention, or
erectile disorder or
Visible hematuria. [2015]
Years of age)
Prostate-specific antigen threshold (micrograms/liter)
Less than 40
Use judgment
40 to 49
More than 2. 5
50 to 59
More than 3. 5
60 to 69
More than 4. 5
70 to 79
More than 6. 5
Above 79
Use judgment
For a brief explanation of why the committee issued the 2021 recommendation and how it might apply, see the section on fundamentals and effects of PSA testing for prostate cancer.
The full main points of the evidence and committee discussions can be discovered in Evidence Review A: PSA Test for Prostate Cancer.
45 years of age or older and:
visible hematuria that persists or recurs after successful treatment of a urinary tract infection, or
60 years of age or older with non-visible and unexplained hematuria and dysuria or accumulation of motile leukocytes on a blood test. [2015]
unexplained visual hematuria, urinary tract infection, or
Visible hematuria that persists or recurs after successful treatment of a urinary tract infection. [2015]
a mass on the penis or an ulcerated lesion, where a sexually transmitted infection has been identified as the cause, or
Persistent injury to the penis after treatment for a sexually transmitted infection ends. [2015]
Main characteristics of the lesions (marking 2 issues each):
resizing
Irregular shape
irregular color.
Least of the injuries (scoring 1 point each):
diameter greater than 7 mm or more
inflammation
oozing
change of sensation.
An unexplained lump in the neck. [2015]
Unexplained ulceration in the hollow oral space that lasts more than 3 weeks or
A persistent, unexplained lump in the neck. [2015]
a lump in the lip or oral cavity, or
a o and white spot in the hollow buccal space compatible with erythroplakia or erythroleukoplakia. [2015]
a lump on the lip or in the hollow mouth space compatible with the mouth, or
a o and white spot in the hollow buccal space compatible with erythroplakia or erythroleukoplakia. [2015]
pallor
unexplained or recurrent infection
generalized lymphadenopathy
unexplained bruising
unexplained bleeding
Unexplained petechiae
hepatosplenomegaly. [2015]
pallor
persistent fatigue
unexplained fever
unexplained infection
generalized lymphadenopathy
persistent or unexplained bone pain
unexplained bruising
unexplained bleeding. [2015]
Separate recommendations were made for adults and youth to recognize that there are other referral pathways. In practice, other young people (aged 16 to 24) may be referred through one address or another depending on their age and local arrangements. .
Separate recommendations were made for adults and youth to recognize that there are other referral pathways. In practice, other young people (aged 16 to 24) may be referred through one address or another depending on their age and local arrangements. .
Separate recommendations were made for adults and youth to recognize that there are other referral pathways. In practice, other young people (aged 16 to 24) may be referred through one address or another depending on their age and local arrangements. .
NICE has published a guide to the physical care experience of infants, children and young people.
A palpable mass
an unexplained enlarged organ
Unexplained visual hematuria. [2015]
Some symptoms or combinations of symptoms may be characteristic of several other cancers. For some of these symptoms, the individual cancer risk may be low, but the overall risk of cancer, regardless of its type, may be higher. Include recommendations for those symptoms.
evaluate other symptoms, symptoms, or effects that may explain which cancer is more likely, and
Propose an urgent investigation or referral to a suspected cancer patient (for an appointment within 2 weeks). [2015]
evaluate other symptoms, symptoms, or effects that may explain which cancer is more likely, and
Propose an urgent investigation or referral to a suspected cancer patient (for an appointment within 2 weeks). [2015]
evaluate other symptoms, symptoms, or effects that may explain which cancer is more likely, and
Consider an urgent investigation or referral to a patient with suspected cancer (for an appointment within 2 weeks). [2015]