Cancer self-referral

Below are various criteria that you should look through if you are worried about any symptoms that you have. You should contact us if you meet any of the criteria, but please be aware that these symptoms may be explained by other causes, and that this is not necessarily cancer. This is just an indicator that you should be booked in for an appointment.

Lung and Pleural Cancers

Upper gastrointestinal tract cancers

Oesophageal Cancer

Please contact us if

You have difficulty swallowing, are vomiting blood, or are aged 55 experiencing weight loss and any of the following symptoms:

• Upper abdominal pain
• Reflux
• Indigestion

You are 55 or over with treatment-resistant indigestion, or have upper abdominal pain, or have a raised platelet count and any of the following:

• Nausea
• Vomiting
• Weight loss
• Reflux
• Indigestion
• Upper abdominal pain

You are over 55 and experience nausea and vomiting with any of the following:

• Weight loss
• Acid Reflux
• Indigestion
• Upper abdominal pain

Pancreatic Cancer

Please contact us if

You are aged 40 or over and have jaundice.

You are aged 60 or over with weight loss and any of the following:

• Diarrhoea
• Back pain
• Abdominal pain
• Nausea
• Vomiting
• Consipation
• New onset diabetes

Stomach Cancer

Please contact us if

You are vomiting blood

Gall bladder Cancer and Liver Cancer

Please contact us if

You have an upper abdominal mass emerging.

Lower gastrointestinal tract cancers

Colorectal Cancer

Please contact us if

You are aged 40 or over and have unexplained weight loss and abdominal pain, or are aged 50 or over and have unexplained rectal bleeding, or are aged 60 and over with either iron-deficiency anaemia or changes in your bowel habits.

You have a rectal or abdominal mass.

If you are aged under 50 and have rectal bleeding and any of the following unexplained symptoms or findings:

• Abdominal pain
• Change in bowel habit
• Weight loss
• Iron-deficiency anaemia

If you do not have rectal bleeding but are:

• Aged 50 and over with unexplained abdominal pain or weight loss.
• Aged under 60 with changes in your bowel habits or iron-defiency anaemia.
• Aged 60 and over and have anaemia even in the absence of iron deficiency.

Anal Cancer

Please contact us if

You have an unexplained anal mass or unexplained anal ulceration.

Breast Cancer

Please contact us if

You have an unexplained breast lump with our without pain or you’re aged 50 and over with either discharge or retraction in one nipple only . Please also contact us if you notice any other changes of concern.

You experience skin changes or are aged 30 and over with an unexplained lump in the armpit.

Gynaecological cancers

Ovarian Cancer

Please contact us if

You have any of the following on a persistent or frequent basis, especially more than 12 times per month:

• Persistent abdominal distension (bloating)
• Feeling full and/or loss of appetite
• Pelvic or abdominal pain
• Increased and/or more frequent need to urinate

Endometrial Cancer

Please contact us if

You have post-menopausal bleeding (unexplained vaginal bleeding more than 12 months after menstruation has stopped because of the menopause).

If you are aged 55 or over and have unexplained symptoms of vaginal discharge and any of the following:

• Have had these symptoms for the first time
• Have thrombocytosis
• Have blood in your urine

If you are aged 55 or over and have visible blood in your urine and one of the following:

• Low haemoglobin levels
• Thrombocyytosis
• High blood glucose levels

Vaginal or Vulval Cancer

Please contact us if you have an unexplained vulval lump, ulceration, or bleeding, or if you have an unexplained mass in or at the entrance to the vagina.

Urological Cancers

Prostate Cancer

Please contact us if

You have:

• any lower urinary tract symptoms, such as nocturia, urinary frequency, hesistancy, urgency or retention.
• Erectile dysfunction
• Visible blood in your urine

Bladder Cancer

Please contact us if

You are aged 45 or over and have unexplained visible blood in your urine without a urinary tract infection or you have visible blood in your urine that persists or recurs after successful treatment of a urinary tract infection.

If you are aged 60 or over and have unexplained non-visible blood in your urine and pain and/or a burning sensation when urinating.

If you are aged 60 or over and have a persistent unexplained urinary tract infection.

Renal Cancer

Please contact us if

You are aged 45 and over and have unexplained visible blood in your urine without a urinary tract infection, or visible blood in your urine that persists or recurs after successful treatment of the urinary tract infection.

Testicular Cancer

Please contact us if

If you have non-painful enlargement or change in shape or texture of the testis, or have unexplained or persistent testicular symptoms.

Penile Cancer

Please contact us if

A mass or ulcerate lesion that is definitely not a sexually transmitted infection; or a persistent penile lesion after treatment for a sexually transmitted infection has been completed.

If you have unexplained or persistent symptoms affecting the foreskin or glans.

Skin Cancers

Malignant Melanoma of the Skin

Please contact us if

You have a pigmented skin lesion and have 3 points or more on the following checklist:

• Change in size (2 points)
• Irregular shape (2 points)
• Irregular colour (2 points)
• Largest diameter of 7mm or more (1 point)
• Inflammation (1 point)
• Oozing (1 point)
• Change in sensation (1 point)

Basal Cell Carcinoma

Please contact us if you have a skin lesion that includes an ulcer with a raised rolled edge, prominent fine blood vessels around the lesion, or a nodule on the skin.

Head and Neck Cancers

Laryngeal Cancer

Please contact us if

You are aged 45 or over and have either persistent unexplained hoarseness or an unexplained lump in your neck.

Oral Cancer

Please contact us if

You have either an unexplained ulceration inside your mouth or on your lips which lasts for more than 3 weeks, or a persistent and unexplained lump in your neck.

You have a lump on your lip or in your mouth or have a red/red and white patch on your lip or in your mouth which looks like erythroplakia.

Thyroid Cancer

Please contact us if

You have an unexplained lump on your thyroid (around your neck).

Brain and Central Nervous System Cancers

Please contact us if

For adults, if you have progressive loss of nervous system functioning. For children, if your child has newly arisen nervous system behaviour.

Haematological Cancers

Leukaemia

Please contact us if

You have any of the following:

• An unhealthy, pale appearance
• Persistent fatigue
• Unexplained fever
• Unexplained persistent or recurrent infection
• Lymphadenopathy (swollen lymph nodes)
• Unexplained bruising
• Unexplained bleeding
• Unexplained petechiae (pinpoint red spots on your skin)

Myeloma

Please contact us if

You have persistent bone pain, particularly back pain, or unexplained fracture.

Hodgkin’s and non-Hodgkin’s Lymphoma

Please contact us if

You have unexplained lymphadenopathy (swollen lymph nodes), especially if you have accompanying symptoms of fever, night sweats, shortness of breath, itchy skin, or weight loss.

Sarcomas

Please contact us if

You have unexplained bone swelling or pain or have an unexplained lump that is increasing in size.

Childhood Cancers

Neuroblastoma

Please contact us if your child has a observable mass around their abdomen or unexplained enlarged abdominal organ.

Retinoblastoma

Please contact us if your child has an absent red reflex.

Wilms’ tumour

Please contact us if your child has any of the following:

• An observable mass around their abdomen
• An unexplained enlarged abdominal organ
• Unexplained visible blood in their urine