Reviewed on : 22 Oct 2026

Reviewed by : Jack Bambrough

Expires : 22 Oct 2028

Introduction

This page is for patients with suspicion of hepatic/pancreatic/biliary cancer. There is now a separate referral form for oesophageal/gastric cancer which can be found here.

Inclusion criteria

This pathway is for:

• Jaundice and aged 40 years
• CT or MRI suggests pancreatic, gallbladder, biliary, liver or duodenal cancer
• USS suggestive of gallbladder or liver cancer

How to refer

All referrals must be made via the NHS e-Referral Service (eRS) using the Urgent Suspected Upper GI Hepato-pancreato-biliary Cancer (USC) referral form. Please attach relevant scan reports to referral.

Please include a clear clinical narrative to aid with timely and appropriate triage. Referrals without sufficient clinical information may be difficult to triage and could result in patient delays.

Required investigations

Please ensure prior to or within 3 months of referral, where possible, that patients have the following to aid clinical triage:

• FBC
• U&Es inc. eGFR
• Clotting
• LFTs

Important information for patients

Please inform the patient this is an urgent suspected cancer referral.

Provide urgent suspected cancer information (CRUK Your USC referral) as leaflet or via Accurx.

Confirm availability and any access or communication needs at the point of referral.

What to do when patient does not meet USC criteria:

If your patient does not fit the criteria above, consider URGENT direct access CT/ultrasound scan (within 2 weeks) to assess (as per NICE CKS guidance):

• Patients aged 60 years and over WITH weight loss AND any of:
  • diarrhoea
  • back pain
  • abdominal pain
  • nausea
  • vomiting
  • constipation
  • new-onset diabetes

Referral forms and pathways

USC Upper GI Hepato-pancreato-biliary form (blank)

Links and documents

USC Upper GI Oesophageal-Gastric page

NICE CKS: Referral for suspected GI tract (upper) cancer

CRUK Patient Information (CRUK Your USC referral)

Authors:October 2026

Dr Miyah Khela

Dr Hazel Blanchard