Last reviewed: 22 April 2025
Last reviewed: 22 April 2025
Scottish Referral Guidelines for Suspected Cancer (SRG, 2025) recommend referring a person with any of the following to a non-specific symptom pathway (RCDS or GP direct access to CT) as an Urgent Suspicion of Cancer (USC) pathway:
New unexplained weight loss (either documented 5% or more of body weight in three months or with strong clinical suspicion)
New unexplained loss of appetite, fatigue, nausea, malaise, or bloating of four weeks or more (less if strong clinical suspicion)
New unexplained, unexpected, or progressive pain, including bone pain, of four weeks or more
GP ‘gut feeling’ of cancer diagnosis
In Scotland, RCDS aim to support the diagnosis of adults who don’t clearly fit into a single USC referral pathway, but who are at risk of being diagnosed with cancer.
In areas where RCDSs aren't available yet, GPs have direct access to CT scans instead.
If a person presents with a combination of symptoms that could indicate several different cancer types, referral to RCDS or GP direct access to CT may be appropriate.
NHS Scotland have published a national evaluation of these pathways, which outlines the impact of the service, patient acceptability and components of an optimal RCDS. Click here(link is external) for more information.
Tips for managing patients with non-specific symptoms
