Cancer Referral Pathways

Question 1

What are the indications for an urgent 2w CXR referral?

Answer 1

Patient aged 40+ with

• Two symptoms (1 if smoked): Unexplained chest pain or cough, SOB, weigh loss, fatigue.
• One sign: Finger clubbing or chests signs or thrombocytosis or cervical lymphadenopathy or recurrent chest infection

Question 2

To whom would you refer a 45 year old patient presenting with unexplained and persistent hoarseness?

Answer 2

Head and neck 2ww

Question 3

What is the criteria for a 2ww wait referral for suspected lung cancer?

Answer 3

CXR findings suggestive of lung cancer

40+ with unexplained haemoptysis

Question 4

What is the criteria for urgent access upper GI endoscopy to assess for oesophageal or stomach cancer?

Answer 4

Dysphagia OR

55+, Weight loss + upper abdominal pain, reflux or dyspepsia

Question 5

What is the 2ww referral criteria for pancreatic cancer?

Answer 5

40+ and jaundice

Question 6

What is the referral criteria for 2ww for colorectal cancer?

Answer 6

40+ with unexplained weight loss and abdominal pain
50+ with unexplained rectal bleeding
60+ with iron deficiency anaemia or changes in Bowel habit
Test show occult blood in faeces

Question 7

What is the referral criteria for breast cancer?

Answer 7

30+ unexplained breast lump

50+ with unilateral nipple symptoms

Question 8

What’s the 2ww referral criteria for prostate cancer?

Answer 8

Suspicious DRE

PSA levels above age specific reference range

Question 9

What is the criteria for 2ww for melanoma?

Answer 9

Suspicious pigmented skin lesion with a weight 7-point checklist score of 3 or more.

Question 10

What is the weighted 7 point checklist for melanoma?

Answer 10

Major feature of lesion (score 2 points each):
Change in size
Irregular shape
Irregular colour
Minor features of the lesion (score 1 point each):
Largest diameter 7mm+
Inflammation 
Oozing
Change in sensation