Guidelines and referral pathways in Scotland
Guidelines and referral pathways in Scotland
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:
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New unexplained weight loss (either documented 5% or more of body weight in three months or with strong clinical suspicion)
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New unexplained loss of appetite, fatigue, nausea, malaise, or bloating of four weeks or more (less if strong clinical suspicion)
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New unexplained, unexpected, or progressive pain, including bone pain, of four weeks or more
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GP ‘gut feeling’ of cancer diagnosis
Rapid Cancer Diagnostic Services (RCDS)
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 for more information.