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Abdominal pain - NICE urgent cancer referral guidance

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Abdominal pain with weight loss (unexplained), 40 and over) - urgent cancer referral guidance

Symptom and Specific Features

Possible Cancer

Recommendation

Abdominal pain with weight loss (unexplained), 40 and over)

Colorectal

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

 

Symptom and Specific Features

Possible Cancer

Recommendation

Abdominal pain (unexplained) with rectal bleeding in adults under 50)

Colorectal

Consider a suspected cancer pathway referral (for an appointment within 2 weeks)

 

Symptom and Specific Features

Possible Cancer

Recommendation

Abdominal pain without rectal bleeding, 50 and over

Colorectal

Offer testing for occult blood in faeces (faecal immunochemical testing)

Check FBC

 

Upper abdominal pain - urgent cancer referral guidance

Symptom and Specific Features

Possible Cancer

Recommendation

Upper abdominal pain with weight loss, 55 and over

Stomach or oesophageal

Offer urgent direct access upper gastrointestinal endoscopy (to be performed within 2 weeks)

 

Symptom and Specific Features

Possible Cancer

Recommendation

Upper abdominal pain with low haemoglobin levels or raised platelet count or nausea or vomiting, 55 and over

Oesophageal or stomach

Consider non-urgent direct access upper gastrointestinal endoscopy

 

Abdominal or pelvic pain (persistent or frequent - particularly more than 12 times per month) in women, especially if 50 and over

 

Symptom and Specific Features

Possible Cancer

Recommendation

Abdominal or pelvic pain (persistent or frequent - particularly more than 12 times per month) in women, especially if 50 and over

Ovarian

Measure Ca-125

 

Abdominal pain with weight loss, 60 and over

Symptom and Specific Features

Possible Cancer

Recommendation

Abdominal pain with weight loss, 60 and over

Pancreatic

Consider an urgent direct access CT scan (to be performed within 2 weeks), or an urgent ultrasound scan if CT is not available

 

Irritable bowel syndrome symptoms within the last 12 months in women 50 and over

Symptom and Specific Features

Possible Cancer

Recommendation

Irritable bowel syndrome symptoms within the last 12 months in women 50 and over

Ovarian

Carry out appropriate tests for ovarian cancer, because irritable bowel syndrome rarely presents for the first time in women of this age

Measure serum CA125 in primary care

Reference:


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