Publication - Advice and guidance

Scottish referral guidelines for suspected cancer: quick reference guide

Published: 22 Jan 2019
Community Health and Social Care Directorate
Part of:
Health and social care

User-friendly visual aid to the urgent referral criteria as well as routine referral criteria and primary care management and good practice points.

50 page PDF

3.0 MB

50 page PDF

3.0 MB

Scottish referral guidelines for suspected cancer: quick reference guide
Haematological Cancers

50 page PDF

3.0 MB

Haematological Cancers

Urgent suspicion of cancer referral

  • Blood count/film reported as suggestive of acute leukaemia or chronic myeloid leukaemia*
  • Lymphadenopathy (>2cm) persisting for six weeks or increasing in size or generalised (HIV status should always be checked if generalised)
  • Hepatosplenomegaly in the absence of known liver disease
  • Bone pain associated with a paraprotein and/or anaemia
  • Bone x-rays reported as being suggestive of myeloma
  • The following clinical features may also merit urgent referral:
  • fatigue
  • night sweats
  • weight loss
  • itching
  • bruising
  • recurrent infections
  • bone pain
  • polyuria and polydipsia (hypercalcaemia)

*will normally be identified in the laboratory and communicated to the clinician for management to be agreed.

Good practice points

  • For people presenting with non-specific symptoms, the clinician should always consider checking human immunodeficiency virus (HIV) status along with other routine investigations
  • Routine tests and investigations should be repeated at least once if a person’s condition remains unexplained
  • If myeloma is suspected, urine as well as serum electrophoresis should be performed

Primary care management

  • CLL in an older person should be discussed with a local haematologist but many cases do not require detailed haematological review
  • Asymptomatic monoclonal gammopathy may be followed up in primary care depending on local arrangements – consider discussion with a haematologist if any concern


Email: Cancer Access Team