Reviewed on : 3 Jul 2020

Reviewed by : GP Gateway Editor

Expires : 3 Jul 2022

TWO WEEK REFERRAL SERVICES – GI LOWER

Indications for an urgent referral for a suspected new malignancy are shown below – see preview of document

FIT testing can now be requested at time of referral (see below)

Follow this link to a video explaining the role of FIT in the diagnostic pathway for bowel cancer

Pre-investigations required:

• Digital Rectal Examination.
• FBC (Hb and Ferritin), LFTs, and U&Es at time of referral, unless taken during the preceding 1 month.

Exemptions:

Rectal Bleed Clinic New symptoms of bright red rectal bleeding should be referred to the respective Rectal Bleed Clinic or Colorectal Clinic unless there is an additional reason to suspect colorectal cancer.

FIT Testing

FIT Testing – follow link

FIT can be requested for symptomatic patients who do not meet the criteria for referral on the colorectal cancer 2WW pathway.

Several lower gastrointestinal symptoms can suggest colorectal cancer, including rectal bleeding, a change in bowel habits, weight loss, anaemia, abdominal pain, and blood in stools (faeces).

Where blood in stools is not visible (faecal occult blood) FIT tests can be used to detect its presence.

If patients with clinical indications of a malignancy do not fit above criteria then please discuss with the respective Lower GI consultant

All 2WW referrals should be made through the NHS eReferral Service (previously known as Choose & Book).

Consider handing the patient a Cancer Research UK Information Sheet – follow link

Preview of 2WW Form