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Colorectal: Guidelines for Urgent Referral
It is recommended that these symptom and sign combinations WHEN
OCCURRING FOR THE FIRST TIME should be used to identify patients for
urgent referral under the two week standard.
| Age Threshold
|
- Rectal bleeding WITH a change in bowel habit to
looser stools and/or increased frequency of defecation persistent
for 6 weeks.
| All ages |
- A definite palpable right-sided abdominal mass.
| All ages |
- A definite palpable rectal (not pelvic) mass.
| All ages |
- Rectal bleeding persistently WITHOUT anal symptoms*
| Over 60 yrs† |
- Change of bowel habit to looser stools and/or increased
frequency of defecation, WITHOUT rectal bleeding
and persistent for six weeks.
| Over 60 yrs† |
- Iron deficiency anaemia WITHOUT an obvious cause
(Hb < 11 g/dl in men or < 10 g/dl in postmenopausal women).
| |
NB. Patients with the following symptoms and no abdominal or rectal mass,
are at very low risk of cancer:
- Rectal bleeding with anal symptoms*
- Change in bowel habit to decreased frequency of defecation and
harder stools.
- Abdominal pain without clear evidence of intestinal obstruction.
* Anal symptoms include soreness, discomfort, itching, lumps and prolapse as
well as pain.
† Age 60 years is considered to be the maximum age threshold. Local Cancer
Networks may elect to set a lower age threshold (eg 55 years or 50 years)
Suspected Cancer
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