Should I see a bowel cancer specialist? | Cancer Research UK
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Should I see a bowel cancer specialist?

Men and women discussing bowel cancer

This page tells you about the guidelines that GPs in the UK have to help them refer people appropriately for bowel cancer tests. You can find the following information

 

A quick guide to what's on this page

Should I see a bowel cancer specialist?

It can be very difficult for GPs to decide who may have a suspected cancer and who may have something more minor. Bowel symptoms are usually caused by something less serious than cancer.

The NICE guidelines

The National Institute for Health and Care Excellence (NICE) has produced guidelines to help GPs decide which patients need to be seen urgently by a bowel specialist (gastroenterologist). This should happen within 2 weeks. The symptoms that need urgent referral are

  • Aged 40 years or more with unexplained weight loss and tummy (abdominal) pain
  • Aged 50 years or more with unexplained bleeding from the back passage (rectum)
  • Aged 60 years or more with iron deficiency anaemia or changes in bowel habit or if a test has shown blood in your poo.

Your GP should consider urgently referring you to a bowel specialist if you have

  • A lump or swelling in your tummy (abdomen) or back passage (rectum).

Your GP should also consider urgently referring you if you are

  • Aged 50 or less with bleeding from the back passage (rectum) and have tummy (abdominal) pain, a change in bowel habit, weight loss or a type of anaemia called iron deficiency anaemia

Your GP should offer you a test to check for blood in your poo, if you are

  • Aged 50 or more with unexplained tummy (abdominal) pain or weight loss or
  • Aged 60 or less with changes in your bowel habit or have iron deficiency anaemia  or
  • Aged 60 or more and have anaemia

If you are concerned that your GP is not taking your symptoms as seriously as they should, you could print this page and talk it through with them at an appointment.

 

CR PDF Icon You can view and print the quick guides for all the pages in the about bowel cancer section.

 

 

GP guidelines

It can be very difficult for GPs to decide who may have a bowel cancer and who may have something much more minor that will go away on its own. Bowel symptoms are very common. Usually they are related to something less serious than cancer, such as piles (haemorrhoids) or infection. So with many symptoms, it is perfectly right that your GP should ask you to wait to see if they get better or respond to treatment such as antibiotics. If GPs referred everyone who came to see them to a specialist immediately, the system would get jammed and people needing urgent appointments wouldn't be able to get them.

Seeing a specialist

The National Institute for Health and Care Excellence (NICE) has produced guidelines for GPs to help them decide which patients need to be seen urgently by a specialist. The guidelines set out the symptoms that could be due to a bowel cancer. People with these symptoms should be seen by a specialist in bowel conditions within 2 weeks of going to their GP. This is called an urgent referral.

 

Who needs to see a specialist urgently?

The guidelines say that you should see a specialist within 2 weeks of seeing your GP if you are

  • Aged 40 and over with unexplained weight loss and tummy (abdominal) pain or
  • Aged 50 and over with unexplained bleeding from your back passage (rectum) or
  • Aged 60 and over with low blood iron levels (iron deficiency anaemia) or changes in your bowel habit or test results that showed blood in your poo (stools).

Your GP should consider referring you to see a specialist urgently if you have 

  • A swelling or lump in your tummy (abdomen) or back passage (rectum).

Your GP should also consider referring you urgently if you are

  • Aged 50 or less with bleeding from your back passage and have any of the following symptoms - tummy (abdominal) pain, a change in bowel habit, weight loss or a type of anaemia called iron deficiency anaemia.

Your GP should offer you a test to check for blood in your poo (stools) even if you don't have bleeding from your back passage, but have the following 

  • Aged 50 or more with unexplained tummy (abdominal) pain or weight loss or
  • Aged 60 or less with changes in your bowel habit or low blood iron levels (iron deficiency anaemia) or
  • Aged 60 or more and are anaemic

Unexplained low blood iron levels (anaemia) could be due to bleeding from a bowel cancer. So GPs should refer people with unexplained anaemia for tests.

 

If you are worried

If you have symptoms and are worried that your GP is not taking them as seriously as you think they should, you could print this page and take it along to an appointment. Ask your GP to talk your symptoms through with you. Then you may be able to decide together whether you need to see a specialist and if so, how soon.

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Updated: 23 June 2015