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  Two-Week Wait Rule - Suspected Cancer  
Referral Guidelines for Suspected Cancer (Two week wait rule) based on NICE Guidance 2005
Last Updated October 2012.

Upper Gastrointestinal Cancer

Urgent Referral

Refer urgently patients presenting with

  • dysphagia
  • unexplained upper abdominal pain and weight loss, with or without back pain
  • upper abdominal mass
  • obstructive jaundice (depending on clinical state)
  • aged > 55 years with unexplained and persistent recent-onset dyspepsia alone

Consider Urgent Referral

  • persistent vomiting
  • unexplained weight loss
  • iron deficiency anaemia (Hb <11g/dl for men or <10g/dl for women)
  • Unexplained worsening of dyspepsia and:
    • Barrett's oesophagus
    • known dysplasia, atrophic gastritis or intestinal metaplasia
  • peptic ulcer surgery over 20 years ago




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Last Update: 31 January 2008