The new NICE referral guideline for suspected cancer explained
Tuesday 23 June 2015
Today the National Institute for Health and Care Excellence (NICE) published its final guideline for the referral of suspected cancer. This guideline supports GPs to identify patients who are experiencing symptoms that could be cancer and refer them for further investigation. Patients who meet the criteria for suspected bowel cancer are referred through the two-week wait pathway. This means that patients referred through this route must be seen by a specialist within two weeks of being referred by their GP. The guideline applies in England, Wales and Northern Ireland. Separate guidelines apply in Scotland.
What did we call for?
When NICE consulted on a draft of the guideline last year we called for it to be liberalised to make it easier to refer people. This is because the previous referral guideline for suspected bowel cancer was restricted to those with 'high-risk' symptoms, such as rectal bleeding in people over 60, yet many people who visited their GP and went on to receive a diagnosis of bowel cancer would not have presented with the high-risk symptoms to qualify them for an urgent referral. This means patients had to see their GP multiple times – sometimes more than five times. These patients often take longer to be diagnosed and have a worse prognosis.
What's changed in the guideline?
In short, the new guideline offers a radical shake up to the previous referral guideline. NICE have taken on board our calls for the guideline to be liberalised and have lowered the threshold at which patients can be referred urgently. Changes include:
- the removal of the restriction to 6 weeks of symptoms before referral
- a wider spectrum of symptoms e.g. weight loss and abdominal pain in patients over 40
- removal of the threshold for anaemia levels.
This means patients with persistent 'low risk' symptoms will be assessed more quickly. As symptoms of bowel cancer can often be vague, this is really good news. Importantly, after persistent campaigning through our 'Never too Young' work, NICE have included referral criteria for patients under the age of 50. You can read the full set of recommendations for the referral of suspected bowel cancer here. We hope the liberalisation of the guideline will lead to a reduction in the number of times a patients sees their GP for the same symptoms, enable GPs to refer more patients for a diagnostic test and, most importantly, improve the timeliness of a person's diagnosis. After all, nine out of ten people will survive bowel cancer if diagnosed in the earliest stages.
Don't forget the symptoms of bowel cancer
If you're worried about any of these symptoms, make an appointment with your doctor.
You might experience one, some, or all of the above symptoms. Remember most symptoms will not be bowel cancer but it is important to get it checked out. Even if it is not bowel cancer you'll at least put your mind at rest and if it is bowel cancer, early detection can save your life.