NICE Guidelines for Referral for Suspected Cancer

Early detection of pancreatic cancer can be difficult. Symptoms can be vague or often associated with more common diseases and conditions.

However there are certain symptoms that mean your GP should refer you straight away to a specialist.

The National Institute for Health and Clinical Excellence (NICE) makes recommendations to the NHS on new and existing medicines, treatments and procedures, and treating and caring for people with specific diseases and conditions.

NICE produces clinical guidelines that support clinicians both at primary care level and at hospital level to make appropriate decisions and referrals.

Clinical guidelines on referral for suspected cancer were published in May 2005 to help GPs make decisions about when to refer people to specialists. The guidelines are not about treating cancer.

In these guidelines, Pancreatic Cancer is not covered as a separate cancer but is included under upper gastrointestinal (GI) cancers which also include the oesophagus and stomach.

The specific information relating to Pancreatic Cancer states:

• Smoking is a risk factor for pancreatic cancer
• The most common presenting symptom of pancreatic cancer is abdominal pain which occurs in about 70% of cases
• Jaundice is the next most common symptom and occurs in about 50% of cases
• Non-specific symptoms and signs that are common in pancreatic cancer include nausea and vomiting, weight loss, changes in bowel habits and onset of diabetes

Urgent referral is recommended for the following signs and symptoms

• Jaundice
• Unexplained upper abdominal pain and weight loss, with or without back pain, or
• An upper abdominal mass (a lump that can be felt by your doctor) without dyspepsia(indigestion or heartburn)

For an urgent referral you should be seen within two weeks and ideally should be referred to a team specialising in the management of upper GI cancers, depending upon local arrangements.

If you have jaundice your doctor may arrange for you to have an ultrasound scan urgently and should also arrange for a blood test called a full blood count to be carried out as soon as possible to assist the specialist assessment when you are seen at the hospital.

For further information on the NICE clinical guidelines for suspected cancer click here