weight loss in adults - NICE urgent cancer referral guidance
Last edited 09/2020
Weight loss
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss (unexplained) | Several, including colorectal, gastro-oesophageal, lung, prostate, pancreatic or urological cancer |
Carry out an assessment for additional symptoms, signs or findings that may help to clarify which cancer is most likely Offer urgent investigation or a suspected cancer pathway referral (for an appointment within 2 weeks) |
| Symptom and Specific Features | Possible Cancer | Recommendation |
|
Weight loss (unexplained) aged 60 or over with any of the following:
|
Pancreatic | consider urgent direct access CT scan |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss (unexplained) with abdominal pain, 40 and over | Colorectal | Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss (unexplained) with rectal bleeding in adults under 50 | Colorectal | Consider a suspected cancer pathway referral (for an appointment within 2 weeks) |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss (unexplained) without rectal bleeding, 50 and over | Colorectal |
Offer testing for occult blood in faeces See primary care investigations for more information on tests for occult blood in faeces (faecal immunochemical testing) |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss (unexplained), 40 and over, ever smoked | Lung or mesothelioma | Offer a chest X-ray |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss (unexplained), 40 and over, exposed to asbestos | Mesothelioma | Offer a chest Xray |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss with cough or fatigue or shortness of breath or chest pain or appetite loss (unexplained), 40 and over, never smoked | Lung or mesothelioma | Offer a chest Xray |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss with unexplained splenomegaly in adults | Non-Hodgkin's lymphoma | Consider a suspected cancer pathway referral (for an appointment within 2 weeks). When considering referral, take into account any associated symptoms |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss with unexplained lymphadenopathy in adults | Hodgkin's lymphoma or non-Hodgkin's lymphoma | Consider a suspected cancer pathway referral (for an appointment within 2 weeks). When considering referral, take into account any associated symptoms |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss with upper abdominal pain or reflux or dyspepsia, 55 and over | Oesophageal or stomach | Offer urgent direct access upper gastrointestinal endoscopy (to be performed within 2 weeks) |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss (unexplained) in women | Ovarian |
Measure serum CA125 in primary care |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss with diarrhoea or back pain or abdominal pain or nausea or vomiting or constipation or new-onset diabetes, 60 and over | Pancreatic | Consider an urgent direct access CT scan (to be performed within 2 weeks), or an urgent ultrasound scan if CT is not available |
| Symptom and Specific Features | Possible Cancer | Recommendation |
| Weight loss with raised platelet count or nausea or vomiting, 55 and over | Oesophageal or stomach | Consider non-urgent direct access upper gastrointestinal endoscopy |
Reference:
NICE urgent cancer referral guidance
NICE urgent cancer referral guidance (guidelines with respect to presenting symptoms and signs)