Reviewed on : 17 Dec 2025

Reviewed by : Dr Rebecca Jacques

Expires : 17 Dec 2027

Referral forms and pathways updated November 2025

This page provides information on local guidance to support the

assessment, management, and referral of patients with Urgent

Suspected Gynaecological Cancer, including the Unscheduled

Bleeding on HRT Pathway

Following consultation with both primary and secondary care

stakeholders, the existing USC (2WW) referral form has been updated

to improve the quality of referrals and support more effective triage

An urgent transvaginal ultrasound (TVUS) request pathway is also

available for patients assessed as being at lower risk

Please refer to the GP guidance document linked on this page for further

details

When completing the USC (2WW) referral form, please ensure a full clinical

narrative is provided, including relevant findings from the patient

examination, and that all required sections of the form are completed

as outlined below

Lynch Syndrome

Previously known as hereditary non-polyposis colorectal cancer or HNPCC.

Other cancers which may be associated with Lynch syndrome include:

• endometrial
• ovarian
• stomach
• small bowel
• bile duct / gall bladder
• brain
• pancreas
• urothelial (kidney, ureter and possibly bladder)
• skin
• Some with Lynch syndrome may have more than one primary cancer