urgent referral for suspected upper gastrointestinal (GI) cancer

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Suspected Oesophageal cancer

  • offer urgent direct access upper gastrointestinal endoscopy (to be performed within 2 weeks) to assess for oesophageal cancer n people:
    • with dysphagia or
    • aged 55 and over with weight loss and any of the following:
      • upper abdominal pain
      • reflux
      • dyspepsia

Suspected Stomach cancer

  • consider a suspected cancer pathway referral (for an appointment within 2 weeks) for people with an upper abdominal mass consistent with stomach cancer
  • offer urgent direct access upper gastrointestinal endoscopy (to be performed within 2 weeks) to assess for stomach cancer in people:
    • with dysphagia or
    • aged 55 and over with weight loss and any of the following:
      • upper abdominal pain
      • reflux
      • dyspepsia

Suspected Gall bladder cancer

  • consider an urgent direct access ultrasound scan (to be performed within 2 weeks) to assess for gall bladder cancer in people with an upper abdominal mass consistent with an enlarged gall bladder

Suspected Liver cancer

  • consider an urgent direct access ultrasound scan (to be performed within 2 weeks) to assess for liver cancer in people with an upper abdominal mass consistent with an enlarged liver

Suspected Pancreatic cancer

  • refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for pancreatic cancer if they are aged 40 and over and have jaundice

    Consider an urgent direct access CT scan (to be performed within 2 weeks), or an urgent ultrasound scan if CT is not available, to assess for pancreatic cancer in people aged 60 and over with weight loss and any of the following:

    • diarrhoea
    • back pain
    • abdominal pain
    • nausea
    • vomiting
    • constipation
    • new-onset diabetes

Non Urgent Referral guidance:

Suspected stomach cancer/oesophageal cancer:

  • consider non-urgent direct access upper gastrointestinal endoscopy to assess for stomach cancer/oesophageal cancer in people with haematemesis

  • consider non-urgent direct access upper gastrointestinal endoscopy to assess for stomach cancer/oesophageal cancer in people aged 55 or over with:
    • treatment-resistant dyspepsia or

    • upper abdominal pain with low haemoglobin levels or

    • raised platelet count with any of the following:
      • nausea
      • vomiting
      • weight loss
      • reflux
      • dyspepsia
      • upper abdominal pain, or

    • nausea or vomiting with any of the following:
      • weight loss
      • reflux
      • dyspepsia
      • upper abdominal pain

Reference:

  1. NICE (June 2015). Referral Guidelines for Suspected Cancer.

Last edited 09/2019

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