2 Week Wait Referrals Flashcards
Colorectal cancer 2ww
40yrs with unexplained weight loss and abdominal pain
>50yrs with unexplained rectal bleeding
>60yrs with:
Iron-deficiency anaemia OR changes in their bowel habit
Tests show occult blood in their faeces
Anal cancer 2ww
Consider 2ww referral for anal cancer in people with an unexplained anal mass or unexplained anal ulceration
Melanoma 2ww
- dermoscopy suggests melanoma of the skin
- suspicious pigmented skin lesion with a weighted 7-point checklist score of 3 or more:
Major features of the lesions (2 points each):
* change in size
* irregular shape
* irregular colour
Minor features of the lesions (1 point each):
* largest diameter >7 mm
* inflammation
* oozing
* change in sensation
When to 2ww for breast cancer
(male or female):
>30yrs and have an unexplained breast lump with or without pain
>50yrs with any of the following symptoms in one nipple only:
Discharge
Retraction
Peau d’orange
Other changes of concern
Endometrial cancer 2WW
55yrs with post-menopausal bleeding
(Unexplained vaginal bleeding 12 months after menstruation has stopped because of menopause)
Lichen sclerosis treatment
Commonly women may have lichen sclerosis presents with itching and white spots / white glaze. This is pre-malignant. Can be treated with a potent topical steroid (dermovate).
Thyroid cancer 2ww
Consider 2ww referral people with an unexplained thyroid lump.
Layngeal cancer 2 ww
Consider 2ww referral >45yrs:
* persistent unexplained hoarseness OR an unexplained lump in the neck
2ww Oral cancer
Consider 2ww referral:
* Unexplained ulceration in the oral cavity lasting for more than 3 weeks
OR
A persistent and unexplained lump in the neck
Consider 2ww referral to a dentist:
* A lump on the lip or in the oral cavity OR a red or red and white patch in
the oral cavity consistent with erythroplakia or erythroleukoplakia.
Dental surgeon to refer 2ww if concluded to be consistent with oral cancer; a
lump on the lip or in the oral cavity consistent with oral cancer
OR
a red or red
and white patch in the oral cavity consistent with erythroplakia or erythroleukoplakia.
Lung cancer 2ww
- chest X-ray findings that suggest lung cancer or mesothelioma
- > 40yrs with unexplained haemoptysis
When to do an urgent chest xray for lung cancer?
(to be performed within 2 weeks):
* >40yrs with 2 or more of the following unexplained symptoms OR
* >40yrs if they have ever smoked with 1 or more of the following unexplained symptoms OR
* >40yrs and have been exposed to asbestos with 1 or more of the following unexplained symptoms:
* cough
* fatigue
* shortness of breath
* chest pain
* weight loss
* appetite loss
Consider an urgent chest X-ray (to be performed within 2 weeks):
* >40yrs with any of the following:
* persistent or recurrent chest infection
* finger clubbing
* supraclavicular lymphadenopathy or persistent cervical
lymphadenopathy
* chest signs consistent with lung cancer or pleural disease
* thrombocytosis
2ww for pancreatic cancer
> 40yrs with jaundice
Liver cancer 2ww
upper abdominal mass consistent with an enlarged liver
Gall bladder 2ww
Upper abdominal mass consistent with an enlarged gall bladder
Stomach or oesophageal cancer 2ww
Abdominal mass consistent with stomach cancer.
