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Referral
Upper Gastrointestinal 2WW
Scope
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
The GP should: use e-Referral Service to book an appointment or send the referral.
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: 2WW Upper GI (Medicine Only) - NDHCT - NDDH - RBZ
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
Suspected Upper GI Tract cancer referral form - SystmOne
NDDH Open Access Gastroscopy and Colonoscopy for Investigation of Iron Deficiency Anaemia
Evidence
NICE referral guidelines for suspected cancer
GP Information
Suspected Cancer Guidelines A-Z
NICE referral guidelines for suspected cancer
bmj - New NICE guidance on referral for cancer
bmj - Assessing and referring adult cancers infographic
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
Patient Information
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
Pathway Group
This pathway was signed off by the NHS Devon.
Publication date: November 2016
