Scottish referral guidelines for suspected cancer: quick reference guide

Scottish Referral Guidelines for Suspected Cancer is a quick reference guide for cancer referrals.

Gynaecological Cancers

Urgent Referral

  • Lesions suspicious of cancer on cervix or vagina at speculum examination.
  • Lesions suspicious of cancer on inspection of vulva.
  • Palpable pelvic mass not obviously fibroids.
  • Suspicious pelvic mass on ultrasound.
  • More than one or a single heavy episode of PMB in women over 55 yrs who are not on HRT.
  • Postcoital bleeding age >35 yrs that persists for more than 4 weeks.
  • HRT: unexpected or prolonged bleeding persisting for >4 weeks after stopping HRT.

Non-urgent referrals

  • Any other women with PMB not on HRT.
  • Repeated unexplained postcoital bleeding.
  • In women >45 yrs with persistent abdominal pain or distension, ovarian cancer should be considered and pelvic USS requested.
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