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NICE Suspected Cancer Guidelines Flashcards

Learn the most urgent cancer referrals outlined by NICE (most of the less urgent referrals have not been included)

1
Q

Suspected cancer referral for lung cancer if…(2)

A
  1. CXR findings that suggest lung cancer
  2. Aged >40 with unexplained haemoptysis
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2
Q

Offer urgent CXR (within 2 weeks) to assess for lung cancer or mesothelioma if…

A

Age >40 + 2 or more of the following unexplained symptoms ( 1 if they have ever smoked)
- Cough
- Fatigue
- Shortness of breath
- Chest pain
- Weight loss
- Appetite loss

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3
Q

Consider urgent CXR (within 2 weeks) to assess for lung cancer or mesothelioma if…

A

Age > 40 + any of the following
- Persistent or recurrent chest infection
- Finger clubbing
- Supraclavicular lymphadenopathy or persistent cervical lymphadenopathy
- Chest signs consistent with lung cancer
- Thrombocytosis
- Chest signs compatible with pleural disease

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4
Q

Suspected cancer pathway referral for mesothelioma if…

A

CXR findings suggest mesothelioma

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5
Q

Offer urgent OGD (within 2 weeks) to assess for oesophageal or stomach cancer if…

A
  1. Dysphagia
  2. > 55 + weight loss + any of the following
    - Epigastric pain
    - Reflux
    - Dyspepsia
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6
Q

Suspected cancer pathway referral for pancreatic cancer if…

A

> 40 with jaundice

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7
Q

Offer urgent direct access CT (within 2 weeks) to assess for pancreatic cancer if…

A

> 60 + weight loss + any of the following
- diarrhoea
- back pain
- nausea
- vomiting
- constipation
- new-onset diabetes

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8
Q

Suspected cancer pathway referral for stomach cancer if…

A

Upper abdominal mass consistent with stomach cancer

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9
Q

Urgent USS (within 2 weeks) for HCC or cholangiocarcinoma if…

A

Upper abdominal mass consistent with enlarged liver or gall bladder

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10
Q

Suspected cancer pathway referral for colorectal cancer if…

A

FIT >10mcg HB/g
Rectal or abdominal mass

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11
Q

Suspected cancer pathway referral for anal cancer if…

A

Unexplained anal mass or anal ulceration

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12
Q

Suspected cancer pathway referral for breast cancer if…

A
  1. > 30 with unexplained breast lump
  2. > 50 with unilateral nipple changes
    (skin changes that suggest breast cancer)
    ( >30 with unexplained lump in axilla)
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13
Q

Suspected cancer pathway referral for ovarian cancer if…

A

Ascites and/or pelvic or abdominal mass (which is not uterine fibroids)

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14
Q

Outline tests in primary care for ovarian cancer

A

Bloating, early satiety, pelvic or abdominal pain, urinary frequency or urgency, IBS >50
1. CA125
2. CA125 > 35 - USS abdomen & pelvis
3. USS suspicious - suspected cancer pathway referral

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15
Q

Suspected cancer pathway referral for endometrial cancer if…

A

Age >55 with PMB
(Age <55 with PMB)

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16
Q

Suspected cancer pathway referral for cervical cancer if…

A

Appearance of cervix is consistent with cervical cancer

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17
Q

Suspected cancer pathway referral for vulval cancer if…

A

Unexplained vulval lump, ulceration, or bleeding

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18
Q

Suspected cancer pathway referral for prostate cancer if…

A
  1. Prostate feels malignant on DRE
  2. Possible symptoms of prostate cancer with raised PSA
19
Q

Suspected cancer pathway referral for bladder cancer if…

A
  1. Age >45 + unexplained visible haematuria
  2. Age >60 with + unexplained non-visible haematuria + dysuria/raised WCC
20
Q

Suspected cancer pathway referral for renal cancer if…

A

Age >45 + unexplained visible haematuria

21
Q

Suspected cancer pathway referral for testicular cancer if…

A

Painless enlargement or change in shape of testis

22
Q

Suspected cancer pathway referral for melanoma if…

A
  1. Weighted 7-point checklist score of 3 or more
  2. Dermoscopy suggests melanoma
23
Q

Suspected cancer pathway referral for squamous cell carcinoma of the skin if…

A

Skin lesion consistent with SCC

24
Q

Suspected cancer pathway referral for BCC if…

A

Particular concern over lesion site/size

25
Suspected cancer pathway referral for laryngeal cancer
1. Persistent unexplained hoarseness 2. Unexplained lump in the neck
26
Suspected cancer pathway referral for oral cancer if...
1. Unexplained ulceration >3 weeks 2. Persistent unexplained lump in the neck ( refer to dentist within 2 weeks if lump on lip/oral cavity or erythroplakia)
27
Suspected cancer pathway referral for thyroid cancer if...
Unexplained thyroid lump
28
Urgent direct access MRI head (within 2 weeks) for brain/CNS cancer if....
Adults: progressive, sub-acute loss of CNS function
29
Very urgent referral (within 48 hours) for suspected brain cancer in children or young people if...
New neurological dysfunction
30
Very urgent FBC (within 48 hours) to assess for leukaemia in adults if...
- Pallor - Persistent fatigue - Unexplained fever - Unexplained persistent or recurrent infection - Generalised lymphadenopathy - Unexplained bleeding, bruising, petechiae - Hepatosplenomegaly
31
Immediate specialist assessment for leukaemia in children if...
Unexplained petechiae or hepatosplenomegaly (otherwise offer very urgent FBC)
32
Suspected cancer pathway referral for myeloma if...
Results of protein electrophoresis or bence-jones protein urine test suggest myeloma
33
Suspected cancer pathway referral for non-hodgkins lymphoma if...
Unexplained lymphadenopathy or splenomegaly in adults
34
Very urgent referral for non-hodgkins lymphoma if...
Unexplained lymphadenopathy or splenomegaly in children
35
Suspected cancer pathway referral for Hodgkin's lymphoma if...
Unexplained lymphadenopathy
36
Very urgent assessment for Hodgkin's lymphoma if...
Child presenting with unexplained lymphadenopathy
37
Suspected cancer pathway referral for sarcoma if...
1. XR suggests bone sarcoma 2. USS suggests soft tissue sarcoma
38
Management of unexplained bone swelling and pain in children
1. XR within 48 hours 2. If this is suspicious - specialist assessment within 48 hours
39
Management of unexplained lump that is growing in size in children
1. USS within 48 hours 2. If this is suspicious - specialist assessment within 48 hours
40
Very urgent assessment for neuroblastoma if...
Child with: 1. Palpable abdominal mass 2. Unexplained enlarged abdominal organ
41
Suspected cancer pathway referral for retinoblastoma if...
Child with absent red reflex
42
Very urgent assessment for Wilm's tumour if...
1. Palpable abdominal mass 2. Unexplained enlarged abdominal organ 3. Unexplained visible haematuria
43
Direct access USS for testicular cancer if...
Unexplained or persistent testicular symptoms

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