guideline (for suspected lower GI cancer, urgent ref.)

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Colorectal cancer

Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer if:

  • they are aged 40 and over with unexplained weight loss and abdominal pain or

  • they are aged 50 and over with unexplained rectal bleeding or

  • they are aged 60 and over with:
    • iron-deficiency anaemia or
    • changes in their bowel habit, or

  • tests show occult blood in their faeces

If rectal or abdominal mass:

  • consider a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer in people with a rectal or abdominal mass

Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer in adults aged under 50 with rectal bleeding and any of the following unexplained symptoms or findings:

  • abdominal pain
  • change in bowel habit
  • weight loss
  • iron-deficiency anaemia.

Anal cancer

  • consider a suspected cancer pathway referral (for an appointment within 2 weeks) for anal cancer in people with an unexplained anal mass or unexplained anal ulceration.

Use of FIT (Faecal Immunochemical Test) to identify possible colorectal cancer:

offer FIT to assess for colorectal cancer in adults without rectal bleeding who:

  • are aged 50 and over with unexplained:
    • abdominal pain or
    • weight loss,

  • or are aged under 60 with:
    • changes in their bowel habit or
    • iron-deficiency anaemia,

  • or are aged 60 and over and have anaemia even in the absence of iron deficiency

Reference:

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

Last edited 05/2020 and last reviewed 07/2021

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