NICE 2ww referral criteria - 3 Flashcards
Consider 2ww for laryngeal cancer if >45y +
Unexplained persistent hoarseness
Unexplained neck lump
Consider 2ww for oral cancer if:
Unexplained oral ulcer >3wks
Unexplained persistent neck lump
Consider 2-week dental referral if:
Lip/oral lump
Red/red+white oral patch
(erythroplakia/erythroleukoplakia)
Dentist to consider 2ww for oral cancer if:
Lip/oral lump consistent oral cancer
Patch consistent with erythroplakia/erythroleukoplakia
Consider 2ww for thyroid cancer if:
Unexplained thyroid lump
Consider urgent direct-access MRI for CNS cancer in adult with:
Progressive subacute loss of central neurological function
Consider 48hr referral for CNS cancer in CYP with:
New abnormal cerebellar/CNS function
Consider very urgent (48hr) FBC to assess for leukaemia in adult with
- pallor
- persistent fatigue
- unexplained fever
- unexplained persistent/recurrent infection
- generalised lymphadenopathy
- unexplained bruising
- unexplained bleeding
- unexplained petechiae
- hepatosplenomegaly
Child with unexplained petechiae
Refer for immediate specialist assessment (suspected leukaemia)
Child with hepatosplenomegaly
Refer for immediate specialist assessment (suspected leukaemia)
Offer very urgent (48hr) FBC to assess for leukaemia in child with
- pallor
- persistent fatigue
- unexplained fever
- unexplained persistent infection
- generalised lymphadenopathy
- unexplained bone pain
- unexplained bruising
- unexplained bleeding
> 60y with persistent bone pain
Offer:
FBC, calcium profile, ESR/viscosity
(myeloma)
> 60y with unexplained fracture
Offer:
FBC, calcium profile, ESR/viscosity
(myeloma)
> 60y with symptoms of myeloma + hypercalcaemia/le
Offer very urgent (48hr): protein electrophoresis
+
Bence-Jones urine test
Symptoms of myeloma + raised ESR/viscosity
Consider very urgent (48hr): protein electrophoresis
+
Bence-Jones urine test
Protein electrophoresis/Bence-Jones urine suggest myeloma
2ww referral for suspected cancer (myeloma)
Unexplained lymphadenopathy in adult
Consider 2ww referral for suspected cancer (HL/NHL)
Unexplained splenomegaly in adult
Consider 2ww referral for suspected cancer (NHL)
Unexplained lymphadenopathy in child
Consider very urgent referral (48hr) for specialist assessment (HL/NHL)
Unexplained splenomegaly in child
Consider very urgent referral (48hr) for specialist assessment (NHL)
Xray suggests possible bone sarcoma in adult
Consider 2ww referral for suspected cancer
Xray suggests possible bone sarcoma in child
Consider very urgent referral (48hr) for specialist assessment
Child with unexplained bone swelling/pain
Consider very urgent (48hr) direct-access Xray
(bone sarcoma)
Adult with unexplained lump increasing in size
Consider urgent (2 week) direct access US
(soft tissue sarcoma)
