Upper G.I: Guidelines for Urgent Referral

• Dysphagia – food sticking on swallowing (any age)

• Dyspepsia at any age combined with one or more of the following ‘alarm’ symptoms:

• weight loss
• proven anaemia
• vomiting

• Dyspepsia in a patient aged 55 years* or more with at least one of the following ‘high risk’ features:

• onset of dyspepsia less than one year ago
• continuous symptoms since onset

• Dyspepsia combined with at least one of the following known risk factors:

• Family history of Upper GI cancer in more than 2 first degree relatives
• Barrett’s oesophagus
• Pernicious anaemia
• Peptic ulcer surgery over 20 years ago
• Known dysplasia, atrophic gastritis, intestinal metaplasia

• Jaundice

• Upper abdominal mass

* Age 55 years is considered to be the maximum age threshold. Local Cancer Networks may elect to set a lower age threshold (e.g. 50 years or 45 years).