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Two-Week Wait Rule - Suspected Cancer |
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Referral Guidelines for Suspected Cancer (Two week wait rule) based on NICE Guidance 2005 |
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Last Updated October 2012. |
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Lower Gastrointestinal Cancer |
Urgent Referral
Refer urgently patients
- aged >40 years reporting rectal bleeding with a change of bowel habit 6 weeks
- aged >60 years with rectal bleeding persisting 6 weeks without anal symptoms
- aged >60 years with a change in bowel habit ≥ 6 weeks
- of any age with a right lower abdominal mass consistent with involvement of the large bowel
- of any age with a palpable rectal mass (intraluminal and not pelvic; a pelvic mass outside the bowel would warrant an urgent referral to urology or gynaecology)
- iron deficiency anaemia without obvious cause (Hb < 11g/dl for men or <10g/dl for women)
NOTE:
Patients with the following symptoms and no abdominal or rectal mass are at very low risk of cancer
- rectal bleeding with anal symptoms (soreness, discomfort, itching, lumps and prolapse as well as pain)
- change in bowel habit to decreasing frequency of defaecation and harder stools
- abdominal pains without clear evidence of intestinal obstruction
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