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Should I see a lung specialist?

Men and women discussing lung cancer

This page tells you about the guidelines that UK GPs have to help them refer people appropriately for lung cancer tests. There is information about

 

A quick guide to what's on this page

Should I see a lung specialist?

The symptoms of lung cancer can be very similar to symptoms of other less serious conditions. So it can be very difficult for GPs to decide who might have a cancer and who may have something more minor. 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

When you might need an urgent chest X-ray

Your GP should consider referring you for an urgent chest X-ray (within 2 weeks) if you are over 40 and have any of the following symptoms 

  • A persistent or recurrent chest infection
  • Thickening and broadening of the fingertips, called clubbing
  • Enlarged lymph nodes in your neck or above your collarbone
  • Chest problems such as a cough, shortness of breath or chest pain
  • A high platelet count (thrombocytosis)

When you might need a chest X-ray

You should be offered a chest X-ray if you are over 40 and have 2 or more of the following symptoms, or if you are an ex smoker and have 1 or more of the following symptoms

  • A cough
  • Tiredness (fatigue)
  • Shortness of breath
  • Chest pain
  • Weight loss
  • Loss of appetite

Guidelines for urgent or immediate referral

You should see a specialist urgently (within 2 weeks) if 

  • Your chest X-ray has signs suspicious of lung cancer
  • You are aged 40 or over and coughing up blood 

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

 

 

UK referral guidelines

The symptoms of lung cancer can be very similar to symptoms of other less serious conditions. So it can be very difficult for GPs to decide who may have a cancer and who may have something much more minor that will go away on its own. 

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. People needing urgent appointments wouldn't then be able to get them.

Seeing a specialist

GPs have guidelines from the National Institute for Health and Care Excellence (NICE) to help them decide which patients need to be seen urgently by a specialist. There are particular symptoms that mean your GP should refer you to a specialist straight away. 

The guidelines say that with certain symptoms your doctor should send you for an urgent chest X-ray. If the X-ray shows anything abnormal, then you need to see a specialist. Some symptoms need a referral to a chest specialist and you should see the specialist within two weeks of going to the GP. In Scotland, the Scottish Intercollegiate Guidelines Network (SIGN) has produced very similar guidelines.

 

Who needs an urgent chest X-ray

If you are over 40 and cough up blood or have blood in your phlegm (sputum) you should have an urgent chest X-ray.

Your GP should also consider referring you for an urgent chest X-ray (within 2 weeks) if you are over 40 and have any of the following symptoms 

  • A persistent or recurrent chest infection
  • A particular type of thickening and broadening of the fingertips, called clubbing
  • Enlarged lymph nodes in your neck or above your collarbone
  • Chest symptoms such as a cough, shortness of breath or chest pain
  • A high platelet count (thrombocytosis)
 

Who needs a chest X-ray

You should be offered a chest X-ray if you are over 40 and have 2 or more of the following symptoms, or if you are an ex smoker and have 1 or more of the following symptoms

  • A cough
  • Fatigue (tiredness)
  • Shortness of breath
  • Chest pain
  • Weight loss
  • Loss of appetite
 

Guidelines for urgent referral

According to the NICE guidelines, you should get an appointment within 2 weeks for an urgent referral. You should see a specialist urgently if you have

  • A chest X-ray that has signs suspicious of lung cancer
  • You are aged 40 or over and coughing up blood

 

 

Are symptoms likely to be lung cancer?

Most lung cancers are diagnosed in people older than 60. Only 1 in every 100 is in someone younger than 40. Your GP may be more likely to ask you to have a chest X-ray or see a specialist if you

  • Smoke, or have smoked in the past
  • Have a smoking related lung disease, such as chronic obstructive pulmonary disease (COPD)
  • Have been exposed to asbestos
  • Have had another cancer in the past, especially in the head and neck area

If you are worried that your GP is not taking your symptoms as seriously as you think they should, you could print this page and take it along to an appointment. Ask your GP to talk it 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