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
Brain/Central Nervous System Tumours

50 page PDF

3.0 MB

Brain/Central Nervous System Tumours

Emergency (same day) referral


  • Patients with headache and/or vomiting with papilloedema

Urgent suspicion of cancer referral

Neurological deficit

  • Progressive neurological deficit (including personality, cognitive or behavioural change) in the absence of previously diagnosed or suspected alternative disorders (such as multiple sclerosis or dementia)


  • Any new seizure
  • Seizures which change in character such as
    post–ictal deficit, headache, increased frequency, etc

Good practice points

  • Consider urgent investigation/referral for patients with non-migrainous headaches of recent onset, when accompanied by ‘red flag’ features suggestive of raised intra cranial pressure (for example: woken by headache; vomiting; drowsiness), progressive neurological deficit or new seizure disorder
  • All NHS Boards have pathways for investigation of headaches which should include primary care direct access to imaging
  • If any uncertainty about the presence of papilloedema, the person should be urgently referred to an optometrist for assessment. If there are red-flags suspicious of cancer as detailed above, a simultaneous urgent suspicion of cancer referral to secondary care should be made. If papilloedema is confirmed, the optometrist should refer directly to secondary care
  • An urgent, suspicion of cancer pathway should exist in all NHS Boards for optometrists to refer directly to secondary care for people with optic discs suspicious of papilloedema


Email: Cancer Access Team