Suspected cancer: recognition and referral

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: 


OldNew
Oesophageal1.2.1 Offer urgent, direct access upper gastrointestinal endoscopy (to be done within 2 weeks) to assess for oesophageal cancer in people:
  •  with dysphagia or
  •  aged 55 and over with weight loss and any of the following:
    •  upper abdominal pain
    •  reflux
    •  dyspepsia. [2015]
1.2.1 Refer people using a suspected cancer pathway referral for oesophageal cancer if they:
  • have dysphagia or
  • are aged 55 and over, have experienced weight loss and have any of the following:
    • upper abdominal pain
    •  reflux
    •  dyspepsia. [2015, amended 2025]
Stomach1.2.7 Offer urgent, direct access upper gastrointestinal endoscopy (to be done within 2 weeks) to assess for stomach cancer in people:
  •  with dysphagia or
  •  aged 55 and over with weight loss and any of the following:
    •  upper abdominal pain
    •  reflux
    •  dyspepsia. [2015]
1.2.7 Refer people using a suspected cancer pathway referral to assess for stomach cancer if they:
  • have dysphagia or
  • are aged 55 and over, have experienced weight loss and have any of the following:
    • upper abdominal pain
    •  reflux
    •  dyspepsia. [2015, amended 2025]

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clinical-resource/Suspected-cancer-recognition-and-referral
This guideline covers identifying children, young people and adults with symptoms that could be caused by cancer.