Upper gastrointestinal tract 2WW


This guidance covers the referral of a patient who presents with symptoms suggestive of upper gastrointestinal cancer who should be referred to a team specialising in the management of upper gastrointestinal cancer, depending on local arrangements.

Helicobacter pylori status should not affect the decision to refer for suspected cancer.

GPs can refer a patient they suspect of having cancer to be seen within 14 days by a specialist. GPs must send the referral within 24 hours of the decision to refer.

Please use the referral forms listed on this page to ensure appropriateness. They have been agreed by the Peninsula Cancer Network.


For all patients with new-onset dyspepsia, consider a full blood count to detect iron deficiency anaemia.


Referral Criteria

Oesophageal or gastric cancer

  • Upper GI endoscopy indicates oesophageal cancer
  • Dysphagia
  • Aged 55 and over with weight loss and any of the following
    • Upper abdo pain
    • Reflux
    • Dyspepsia
  • Upper abdominal mass consistent with stomach cancer

Gall bladder cancer

  • Ultrasound indicates gall bladder cancer

Liver cancer

  • Ultrasound indicates liver cancer

Pancreatic cancer

  • Aged 40 and over and have jaundice
  • CT indicates pancreatic cancer
  • Ultrasound indicates pancreatic cancer

The following recent blood results, less than 8 weeks old, would be extremely helpful:

  • FBC
  • U&E
  • LFT
  • Ferritin
  • Iron studies
  • Bilirubin

Referral Instructions

From the 11th December 2017 the RD&E will only take 2WW referrals via the NHS e-Referral Service for Lower GI. GPs will be able to send their referrals to us by using new functionality called a Referral Assessment Service (RAS)

Please ensure you include:

  • The patient's NHS number
  • Tell the patient that this is an urgent referral and they will be seen within 14 days

e-Referral selection:

  • Specialty: 2WW
  • Clinic type: 2WW Upper GI
  • Service: Two Week Wait Colorectal Surgery / Lower GI- RAS-RDE-RH8

The referral will be graded by a Clinician, patients will be booked into either a consultant clinic or day case procedure appointment. RD&E will advise the patient if their appointment date and time.

For any patients that you are unable to process through NHS e-Referral please contact the drss.helpdesk@nhs.net

Referral Forms

Suspected Upper GI Tract cancer referral form - No merge fields

Suspected Upper GI Tract cancer referral form - Emis WEB

Suspected Upper GI Tract cancer referral form - Microtest

Suspected Upper GI Tract cancer referral form - Systmone with Problem Merge field

Suspected Upper GI Tract cancer referral form - Systmone with Summary Merge field


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