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Should I see an oesophageal cancer specialist?

Men and women discussing non oesophageal cancer

This page tells you about the guidelines that GPs have to help them decide who needs to see a specialist for suspected oesophageal cancer and how soon. You can find the following information

 

A quick guide to what's on this page

Should I see an oesophageal cancer specialist?

It can be very difficult for GPs to decide who may have a suspected cancer and who has something much less serious. But some particular symptoms require urgent attention. UK guidelines say that the following symptoms need an urgent referral for an endoscopy within 2 weeks.

  • Difficulty in swallowing (dysphagia) at any age or

If you are aged 55 or over with weight loss and have any of the following

  • Pain in your upper tummy (abdomen)
  • Acid indigestion (reflux)
  • Indigestion (dyspepsia)

Your GP should consider referring you for a non-urgent endoscopy if 

  • You have been vomiting blood (haematemesis) at any age

Your GP should consider referring you for a non-urgent endoscopy if you are aged 55 or over and have the following

  • Indigestion that has not improved with medication
  • Pain in your upper tummy (abdomen) with a low red blood cell count or
  • A raised platelet count with any of the following symptoms - feeling sick (nausea), being sick (vomiting), weight loss, reflux, indigestion (dyspepsia), pain in your upper tummy (abdomen) or
  • Nausea and vomiting with any of the following - weight loss, reflux, indigestion (dyspepsia), pain in your upper tummy (abdomen)

If you have symptoms and do not think your GP is taking them seriously enough, you could print out this page and take it to your appointment.
 

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

 

 

How common oesophageal cancer is

There are around 8,300 cases of oesophageal cancer diagnosed in the UK each year. About 3 out of every 100 cancers diagnosed (3%) are oesophageal cancers. It is more common in men than women and, as with most cancers, is more common in older people.

 

About these guidelines

It can be very difficult for GPs to decide who may have a suspected 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 simple treatments. If GPs referred everyone who came to see them to a specialist immediately, the system would get jammed and those needing urgent appointments wouldn't be able to get them.

Seeing a specialist

The National Institute for Health and Care Excellence (NICE) and the Scottish Government have produced guidelines for GPs to help them decide which patients need to be seen urgently by a specialist. While reading these guidelines, it is important to remember that

  • Indigestion is a very common complaint, and is usually not serious
  • Oesophageal cancer is more common in older people - around 8 in 10 cases (80%) are diagnosed in people aged 60 or over. It is very rare in people under the age of 40.
 

Guidelines for urgent referral

According to NICE guidelines, you should get an appointment within 2 weeks for an urgent referral. You should have an urgent referral for an endoscopy if you have

  • Difficulty in swallowing (dysphagia) at any age or

Are aged 55 or over with weight loss and have any of the following symptoms

  • Pain in your upper tummy (abdomen)
  • Acid indigestion (reflux)
  • Indigestion (dyspepsia)
 

Guidelines for non-urgent referral

Your GP should consider referring you for an endoscopy if 

  • You have been vomiting blood (haematemisis) at any age

Your GP should consider referring you for a non urgent endoscopy if you are aged 55 or over and have

  • Indigestion that has not improved with medication
  • Pain in your upper tummy (abdomen) with a low red blood cell count
  • A raised platelet count with any of the following symptoms - nausea, vomiting, weight loss, acid reflux indigestion or upper tummy pain or

Your GP should also consider referring you for a non urgent endoscopy, if you are aged 55 or over and have nausea and vomiting with the following symptoms

  • Weight loss
  • Acid indigestion (reflux)
  • Indigestion
  • Pain in your upper tummy (abdomen)
 

Risk factors

Your doctor may urgently refer you to a specialist if you have indigestion that is getting worse and you have an increased risk of oesophageal cancer. For example, you have

There is more information about the possible risks factors and symptoms of cancer of the oesophagus in this section.

 

What to do if you are still worried

If you are concerned 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 and 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