Should I see a bowel cancer specialist?
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
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 specialist. The symptoms that may need urgent referral at any age are
- A lump in the abdomen in the area of the large bowel or a lump in your back passage (rectum)
- A type of anaemia called iron deficient anaemia without a known cause
Your GP should also consider urgent referral if you are
- Aged 60 years or more, with bleeding from the back passage for at least 6 weeks or with a change in bowel habit to looser or more frequent stools for at least 6 weeks
- Aged 40 to 59 years with bleeding from the back passage and either a change of bowel habit towards looser stools or increased stool frequency for at least 6 weeks
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.
You can view and print the quick guides for all the pages in the about bowel cancer section.
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.
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 colorectal conditions within 2 weeks of going to their GP. This is called an urgent referral.
The guidelines say that you should see a specialist within 2 weeks of seeing your GP if you are
- Aged 60 years or more, with bleeding from the back passage for at least 6 weeks or with a change in bowel habit to looser or more frequent stools continuing for 6 weeks or more
- Aged 40 to 59 years with bleeding from the back passage and either a change of bowel habit towards looser stools or more frequent stools lasting at least 6 weeks
- Any age and have a lump in your abdomen in the area of your large bowel or in your back passage (rectum)
The guidelines say that unexplained low blood iron levels (anaemia) could be due to bleeding from a bowel cancer. They advise GPs to refer people with unexplained anaemia for tests.
The guidelines point out that people who have the following symptoms, but do not have any lump in the abdomen, are very unlikely to have cancer
- Bleeding from the back passage, with soreness, itching and pain
- A change in normal bowel habits to harder, less frequent stools
- Pain in the abdomen without any sign that there is a blockage of the bowel
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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