2ww Upper and Lower GI
2ww Upper GI referral
≥40y + jaundice [pancreatic cancer]
Upper abdominal mass consistent with stomach cancer [stomach cancer]
2ww Lower GI referral
>40y: unexplained weight loss AND abdominal pain (especially worrying if >60y)
>50y: unexplained rectal bleeding
>60y: iron‑deficiency anaemia OR changes in their bowel habit
<50y: rectal bleeding and any [change in bowel habit, abdominal pain, weight loss or iron‑deficiency anaemia]
[Age]: rectal or abdominal mass
FIT test is positive
Urgent direct access CT Abdomen or Ultrasound Abdomen within 2 weeks
≥60y + weight loss + (any diarrhoea, back pain, abdominal pain, nausea, vomiting, constipation, new‑onset diabetes). [pancreatic cancer]
Urgent direct access Ultrasound Abdomen within 2 weeks
Upper abdominal mass consistent with an enlarged gall bladder [Gall Bladder cancer]
Upper abdominal mass consistent with enlarged liver [Liver cancer]
Urgent direct access Upper GI endoscopy within 2 weeks
Dysphagia [Oesophageal cancer, Stomach cancer]
≥55y + weight loss + (any upper abdominal pain, reflux, dyspepsia) [Oesophageal cancer, Stomach cancer]
Non-urgent direct access Upper GI endoscopy
Haematemesis [Oesophageal cancer, stomach cancer]
[Oesophageal cancer, stomach cancer]:
≥55y + treatment‑resistant dyspepsia
≥55y + upper abdominal pain + low haemoglobin levels
≥55y + raised platelet count + (any nausea, vomiting, weight loss, reflux, dyspepsia, upper abdominal pain)
≥55y + nausea or vomiting + (any weight loss, reflux, dyspepsia, upper abdominal pain)
Quantitative faecal immunochemical tests (FIT) to guide referral for colorectal cancer in primary care
FIT test carried out in low-risk symptomatic populations, without rectal bleeding, who have low probability (0.1%-3%) of colorectal cancer:
≥50y + unexplained weight loss OR abdominal pain
<60y + any change in their bowel habit or iron-deficiency anaemia
≥60y + anaemia without iron deficiency
If FIT positive, then urgent 2ww referral to lower GI for colonoscopy (or CT colonography)
