Lung Cancer

Immediate Referral

Consider immediate referral for patients with

• signs of superior vena cava obstruction (swollen face / neck with fixed elevation of jugular venous pressure (JVP))
• stridor

Urgent Referral

Refer urgently patients with

• persistent haemoptyiss (in smokers or ex-smokers aged 40 years and older)
• a chest X-ray suggestive of lung cancer (including pleural effusion and slowly resolving consolidation)
• a normal chest X-ray where there is a high suspicion of lung cancer
• a history of asbestos exposure and recent onset of chest pain, shortness of breath or unexplained systemic symptoms where a chest X-ray indicates pleural effusion, pleural mass or any suspicious lung pathology

Urgent Chest X-ray :

Refer urgently for chest X-ray (the report should be returned within 5 days) for patients with any of the following

• Haemoptysis
• Unexplained or persistent (longer than 3 weeks)
  • chest and/or shoulder pain
  • dyspnoea
  • weight loss
  • chest signs
  • hoarseness
  • finger clubbing
  • cervical or supraclavicular lymphadenopathy
  • cough
  • features suggestive of metastases from a lung cancer (for example, secondaries in the brain, bone, liver or skin)
• underlying chronic respiratory problems with unexplained changes is existing symptoms