Alarm Features
NICaN Northern Ireland Referral Guidance for Suspected Cancer
- Red flag referral for endoscopy / referral to specialist, patients of any age with dyspepsia and any of the following:
- chronic gastrointestinal bleeding
- dysphagia
- progressive unintentional weight loss
- persistent vomiting
- iron deficiency anaemia
- epigastric mass
- suspicious barium meal results
- Red flag referral for patients presenting with:
- dysphagia
- unexplained upper abdominal pain and weight loss, with or without back pain
- upper abdominal mass without dyspepsia
- obstructive jaundice (depending on clinical state) – consider urgent ultrasound if available
- Consider red flag referral for patients presenting with:
- persistent vomiting and weight loss in the absence of dyspepsia
- unexplained weight loss or iron deficiency anaemia in the absence of dyspepsia
- unexplained worsening of dyspepsia and:
- barrett’s oesophagus
- known dysplasia, atrophic gastritis or intestinal metaplasia
- peptic ulcer surgery over 20 years ago
- Urgent endoscopy:
- patients aged 55 years and older with unexplained and persistent recent-onset dyspepsia alone
|
