Gynaecological Cancer

Urgent Referral

• Clinical features suggestive of cervical cancer on examination. A smear test is not required before referral, and a previous negative result should not delay referral
• Not on HRT with postmenopausal bleeding
• On HRT with persistent or unexplained postmenopausal bleeding after cessation of HRT for 6 weeks
• Taking tamoxifen with postmenopausal bleeding
• With an unexplained vulval lump
• With vulval bleeding due to ulceration
• With a palpable abdominal or pelvic mass on examination that is not obviously uterine fibroids or not of GI or urological origin

Consider Urgent Referral

• Patients with persistent intermenstrual bleeding and negative pelvic examination