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)