2-Week Wait Referrals for Common Cancers

Question 1

2-week wait referral for lung/pleural cancer?

Answer 1

	2-week referral for lung cancer if:
•	CXR findings suggestive of lung cancer
•	>40 with unexplained haemoptysis
	2-week CXR in >40 if they have (unexplained 2 of following or 1 and smoker):
•	Cough
•	Fatigue
•	SOB
•	Chest Pain
•	Weight Loss/Anorexia
•	Other signs of cancer

Question 2

2-week wait referral for oesophageal cancer?

Answer 2

	2-week endoscopy when:
•	Dysphagia
•	Aged >55 with weight loss and:
o	Upper abdominal pain
o	Reflux
o	Dyspepsia

Question 3

2-week wait referral for pancreatic cancer?

Answer 3

	Referral if >40 and have new jaundice
	CT scan/USS if >60 and weight loss with:
•	Diarrhoea
•	Back/Abdominal Pain
•	Nausea
•	Vomiting
•	Constipation
•	Diabetes

Question 4

2-week wait referral for stomach cancer?

Answer 4

	Referral if upper abdominal mass
	Urgent endoscopy in:
•	Dysphagia
•	Aged >55 with weight loss and:
o	Upper abdominal pain
o	Reflux
o	Dyspepsia

Question 5

2-week wait referral for gall bladder/liver?

Answer 5

o Gallbladder Cancer
 USS scan with upper abdominal mass with enlarged gall bladder
o Liver Cancer
 USS scan with upper abdominal mass consistent with enlarged liver

Question 6

2-week wait referral for colorectal cancer?

Answer 6

 Referral if:
• >40 with unexplained weight loss and abdominal pain
• >50 with unexplained rectal bleeding
• >60 with iron-deficiency anaemia or changes in bowel habit
• Occult blood in faeces

Question 7

2-week wait referral for breast cancer?

Answer 7

 Referral if:
• >30 with unexplained breast lump with/without pain
• >50 with any of these symptoms in one nipple:
o Discharge
o Retraction
o Other changes

Question 8

2-week wait referral for prostate cancer?

Answer 8

 Referral if prostate feels malignant on DRE, PSA over limits

Question 9

2-week wait referral for bladder/renal cancer?

Answer 9

 Referral if:
• >45 and have unexplained visible haematuria without UTI or visible haematuria that persists after UTI Rx
• >60 with unexplained haematuria and either dysuria or raised WCC

Question 10

2-week wait referral for head and neck cancer?

Answer 10

o	Laryngeal Cancer
	Referral when >45 with:
•	Persistent unexplained hoarseness OR unexplained lump in neck
o	Oral Cancer
	Referral when:
•	Unexplained ulceration in oral cavity >3 weeks OR perisistent and unexplained lump in neck
o	Thyroid Cancer
	Unexplained thyroid lump

Question 11

2-week wait referral for brain cancer?

Answer 11

 Urgent MRI scan with progressive, sub-acute loss of central neurological function