Abdominal Pain (Suspected Cancer Pathways)

Question 1

Abdominal pain with weight loss (unexplained), 40 years and over). Possible cancer and recommended pathway?

Answer 1

• Colorectal cancer

- Referral for appointment within 2 weeks

Question 2

Abdominal pain (unexplained) with rectal bleeding in adults under 50). Possible cancer and recommended pathway?

Answer 2

• Colorectal cancer

- Referral for appointment within 2 weeks

Question 3

Abdominal pain without rectal bleeding, 50 and over. Possible cancer and recommended pathway?

Answer 3

• Colorectal cancer
• Offer testing for faecal occult blood
• Check FBC

Question 4

Upper abdominal pain with weight loss, 55 and over. Possible cancer and recommended pathway?

Answer 4

• Stomach/oesophageal cancer

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

Question 5

Upper abdominal pain with low haemoglobin levels or raised platelet count or nausea or vomiting, 55 and over. Possible cancer and recommended pathway?

Answer 5

• Oesophageal/stomach

- Consider non-urgent direct access upper gastrointestinal endoscopy

Question 6

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

Answer 6

• Ovarian

- Measure CA-125

Question 7

Abdominal pain with weight loss, 60 and over. Possible cancer and recommended pathway?

Answer 7

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

Question 8

Irritable bowel syndrome symptoms within the last 12 months in women 50 and over. Possible cancer and recommended pathway?

Answer 8

• 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