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Non-Specific Symptoms Pathway for Suspected Cancer (Coventry & Rugby patients only)


Non-specific Symptoms Pathway, designed for those patients with worrying non-site-specific symptoms for whom the GP feels cancer is a potential diagnosis for Coventry and Rugby GPs only.

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Coventry Guidance  
Non-Specific Symptoms Pathway for a Possible Cancer Diagnosis

University Hospital Coventry and Warwickshire (UHCW) NHS Trust is pleased to announce the introduction of a new Non-specific Symptoms Pathway, designed for those patients with worrying non-site-specific symptoms for whom the GP feels cancer is a potential diagnosis.

This service is currently for Coventry and Rugby GPs only.

About the Service

The Clinical Lead for the service is Dr Murthy Narasimha (Consultant in Diabetes & Endocrinology), who will be supported by a team, including Radiology leads, Cancer Care Navigator, and other specialist colleagues.

This pathway aims to:

  • Provide a single referral point, avoiding multiple GP visits and secondary care referrals for those with non-site-specific signs and symptoms for whom the GP feels cancer is a possible diagnosis
  • Provide timely re-assurance when there is a clear ‘no cancer’ diagnosis & refer to the appropriate team or back to the referring GP
  • Where a cancer diagnosis is made facilitate timely referral to the appropriate specialist cancer team, for ongoing management and treatment
  • Provide a positive patient experience, faster diagnosis and improved outcomes in line with cancer waiting time standards and the milestones set out in the NHS long term plan
  • Meet standards of a suspected cancer pathway including details of investigations and any on-going actions or treatment required
  • Provide feedback and information to Primary Care relating to their referred patient
Inclusion Criteria

Age 40+ AND unexplained weight loss

Age 40+ AND constitutional symptoms (+4 weeks)

  • Decreased appetite
  • Nausea and/or vomiting
  • Bloating
  • Non-specific abdominal pain
  • Fatigue
  • Progressive / Unexplained pain / Other pain

Any Age (ADULTS 16+)

  • Anaemia (Hb<100g/L) (not iron deficient, not bleeding)
  • Unexplained night sweats
  • Hepatomegaly (significant with clinical correlation)
  • Splenomegaly (>18cm)
  • Unprovoked DVT with signs and symptoms suggesting underlying cancer
  • Abnormal imaging suggestive of metastatic disease with unknown primary
  • Primary Care Clinicians Gut Instinct
Exclusion Criteria

Post-menopausal bleeding
Abnormal vaginal bleeding
Age 40+ persistent unexplained pain and weight loss in the presence of GI symptoms Haemoptysis
Shortness of breath
Rectal bleeding
Altered Bowel Habits
Lymphadenopathy – Unexplained persistent at other site – refer Haematology
Lymphadenopathy – Axillary – refer Breast Clinic
Lymphadenopathy – Cervical – refer using Head and Neck Suspected Cancer Referral Form


Refer using the established 2WW referral route using the attached form (see right)

Record your referral in the EMIS clinical record using the Snomed code : 3082491000000112 FAST TRACK REFERRAL FOR SUSPECTED CANCER DUE TO NON -SITE-SPECIFIC SYMPTOMS (PROCEDURE)

Remember to save the file to downloads or desktop on your PC and import from EMIS to view the form

Form previewed below:

North Warwickshire Guidance  

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