Lung: Guidelines for Urgent Referral

Note: In most cases where lung cancer is suspected it is appropriate to arrange an urgent chest x-ray before urgent referral to a chest physician.

A Urgent Referral for a Chest X-ray

• Haemoptysis
• Unexplained or persistent (more than 3 weeks)
• cough
• chest/shoulder pain
• dyspnoea
• weight loss
• chest signs
• hoarseness
• finger clubbing
• features suggestive of metastasis from a lung cancer (e.g. brain, bone, liver or skin)
• persistent cervical/supraclavicular lymphadenopathy

B Urgent referral to a Chest Physician

Any of the following:

• Chest x-ray suggestive/suspicious of lung cancer (including pleural effusion and slowly resolving consolidation).
• Persistent haemoptysis in smokers/ex-smokers over 40 years of age.
• Signs of superior vena caval obstruction (swelling of face/neck with fixed elevation of jugular venous pressure).
• Stridor (consider emergency referral).