Publication - Advice and guidance

Scottish referral guidelines for suspected cancer: quick reference guide

Published: 22 Jan 2019
Directorate:
Community Health and Social Care Directorate
Part of:
Health and social care
ISBN:
9781787815292

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

Contents
Scottish referral guidelines for suspected cancer: quick reference guide
Oesophago-Gastric, Hepatobiliary and Pancreatic Cancers

50 page PDF

3.0 MB

Oesophago-Gastric, Hepatobiliary and Pancreatic Cancers

Oesophago-gastric cancer

Urgent suspicion of cancer referral

  • Dysphagia (interference of the swallowing mechanism that occurs within five seconds of the swallowing process) or unexplained odynophagia (pain on swallowing) at any age
  • Unexplained weight loss, particularly >55 years, combined with one or more of the following features:
  • new or worsening upper abdominal pain or discomfort
  • unexplained iron deficiency anaemia
  • reflux symptoms
  • dyspepsia resistant to treatment
  • vomiting
  • New vomiting persisting for more than two weeks

Hepatobiliary and pancreatic cancer

Urgent suspicion of cancer referral

  • Painless obstructive jaundice
  • Unexplained weight loss, particularly >55 years, combined with one or more of the following features:
  • upper abdominal or epigastric mass
  • new onset diabetes
  • any suspicious abnormality, in the hepatobiliary tract, found on imaging (such as biliary dilatation or pancreatic/liver lesion)
  • new onset, unexplained back pain (consider other cancer causes including myeloma or malignant spinal cord compression)
  • ongoing GI symptoms despite negative endoscopic investigations

Oesophago-gastric cancer

Good practice points

Consider routine referral for people presenting with new upper gastrointestinal pain or discomfort combined with any of the following risk factors:

  • family history of oesophago-gastric cancer in a first-degree relative
  • Barrett’s oesophagus
  • pernicious anaemia
  • previous gastric surgery
  • achalasia (dysfunction of the oesophageal muscle)
  • known dysplasia, atrophic gastritis or intestinal metaplasia

Primary care management

  • Dyspepsia without accompanying symptoms or risk factors should be managed according to local or national guidelines

Hepatobiliary and pancreatic cancer

Good Practice Points

  • Consider seeking advice in people presenting with new onset GI symptoms with known chronic liver disease

There is emerging evidence that thrombocytosis is a risk marker for underlying cancer, including gastric and oesophageal. Remember “LEGO-C”.


Contact

Email: Cancer Access Team