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  Two-Week Wait Rule - Suspected Cancer  
     
 
Referral Guidelines for Suspected Cancer (Two week wait rule) based on NICE Guidance 2005
 
Last Updated October 2012.
 

Lung Cancer

Immediate Referral

Consider immediate referral for patients with

  • signs of superior vena cava obstruction (swollen face / neck with fixed elevation of jugular venous pressure (JVP))
  • stridor

Urgent Referral

Refer urgently patients with

  • persistent haemoptyiss (in smokers or ex-smokers aged 40 years and older)
  • a chest X-ray suggestive of lung cancer (including pleural effusion and slowly resolving consolidation)
  • a normal chest X-ray where there is a high suspicion of lung cancer
  • a history of asbestos exposure and recent onset of chest pain, shortness of breath or unexplained systemic symptoms where a chest X-ray indicates pleural effusion, pleural mass or any suspicious lung pathology

Urgent Chest X-ray :

Refer urgently for chest X-ray (the report should be returned within 5 days) for patients with any of the following

  • Haemoptysis
  • Unexplained or persistent (longer than 3 weeks)
    • chest and/or shoulder pain
    • dyspnoea
    • weight loss
    • chest signs
    • hoarseness
    • finger clubbing
    • cervical or supraclavicular lymphadenopathy
    • cough
    • features suggestive of metastases from a lung cancer (for example, secondaries in the brain, bone, liver or skin)
  • underlying chronic respiratory problems with unexplained changes is existing symptoms

 

 
 
     
   
   
   
 

 

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