Overview
This guideline covers identifying children, young people and adults with symptoms that could be caused by cancer. It outlines appropriate investigations in primary care, and selection of people to refer for a specialist opinion. It aims to help people understand what to expect if they have symptoms that may suggest cancer.
We have used the terms 'men' and 'women' in some recommendations on gender-related cancers, but they also apply to people who have changed or are in the process of changing gender, and who retain the relevant organs.
Last reviewed: 1st May 2025
Please find below a summary table showing the key changes made to the recommendations, following stakeholder feedback:
| Old | New | |
| Oesophageal | 1.2.1 Offer urgent, direct access upper gastrointestinal endoscopy (to be done within 2 weeks) to assess for oesophageal cancer in people:
| 1.2.1 Refer people using a suspected cancer pathway referral for oesophageal cancer if they:
|
| Stomach | 1.2.7 Offer urgent, direct access upper gastrointestinal endoscopy (to be done within 2 weeks) to assess for stomach cancer in people:
| 1.2.7 Refer people using a suspected cancer pathway referral to assess for stomach cancer if they:
|
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Clinical Resources
Allurion Gastric Balloon: Updated safety information due to the risks of gastric outlet obstruction, small bowel obstruction and gastric perforation (DSI/2026/004)
clinical-resource/MHRA-DSI-on-the-Allurion-Gastric-Balloon
In rare instances, the Allurion Gastric Balloon has not transited through the stomach or bowel as intended, leading to complications.

Guidance
Endoscopy
British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland guidance on best practice for upper gastrointestinal endoscopy
clinical-resource/Best-practice-for-upper-GI-endoscopy
National root cause analysis of post-endoscopy upper gastrointestinal (UGI) cancer in England has found wide variations in UGI endoscopy quality.