Guidelines and referral pathways in Wales
Guidelines and referral pathways in Wales
NICE NG12 (2015) include recommendations for managing those with certain non-specific symptoms:
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For people with unexplained weight loss (which is a symptom of several cancers including colorectal, gastro‑oesophageal, lung, prostate, pancreatic and urological cancer)
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For people with unexplained appetite loss (which is a symptom of several cancers including lung, oesophageal, stomach, colorectal, pancreatic, bladder and renal cancer)
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For people with deep vein thrombosis, (which is associated with several cancers including urogenital, breast, colorectal and lung cancer):
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carry out an assessment for additional symptoms, signs or findings that may help to clarify which cancer is most likely and
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offer urgent investigation or a suspected cancer pathway referral.
Rapid Diagnosis Clinics (RDC)
Since the last update of NG12 guidelines, patients in all seven Health Boards have access to an RDC, either within their own Health Board, or an adjacent location.
NHS Wales recommends the following inclusion criteria for these pathways:
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People aged 18 years and over
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People who present with non-site-specific symptoms such as unexplained weight loss, severe unexplained fatigue, persistent nausea and/or appetite loss, new atypical pain e.g. abdominal or bone pain
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Unexplained abnormal blood tests - eg anaemia, hypercalcaemia, thrombocytosis
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Where the GP has a ‘gut feeling’ that there is serious underlying disease that is likely to be due to occult malignancy
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Patient is well enough, willing, and able to go through the process and attend the clinic day
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GP has requested ‘Set A’ bloods at the time of referral
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Patient is not suitable for any site-specific urgent pathway
A national evaluation of the services is underway.