Opportunistic public education

Symptom variation from different cancers is vast and there are several red flag symptoms. People should seek medical attention when they have a change in normal function. When assessing people, safety netting should be provided, explaining when and why they should return. Some symptoms that should ring alarm bells are:

Opportunistic Public Education pic

  • Worsening breathlessness
  • Persistent cough
  • Unexplained haemoptysis
  • Voice hoarseness
  • Unexplained vaginal bleeding
  • Post-menopausal bleeding
  • Persistent indigestion
  • Dysphagia
  • Unexplained jaundice
  • Unresolved oral ulcers over 3 weeks
  • Night sweats
  • Breast lumps or changes
  • Abdominal bloating
  • Unexplained weight loss
  • Rectal bleeding
  • Change in bowel habit
  • Haematuria
  • Persistent urinary tract infections
  • Suspicious pigmented skin lesion
  • Urinary urgency and frequency
  • Persistent lump or mass
  • Unexplained pain/ache
  • Persistent and unexplained fatigue
  • Bone pain/swelling

There are some very useful resources to provide support, guidance and practical referral recommendations for general practitioners.

NICE - Suspected cancer: recognition and referral guidelines (June 2015)
This gives healthcare professionals guidance on referral recommendations based on cancer by site of origin. There are some new suggestions that have been added in 2015.
BMJ - Adult cancer infographic identifying NICE guidance on referral for cancer (July 2015)
This is an easy-to-use and colourful infographic on adult referral guidelines for suspected cancer based on symptoms produced by BMJ.
BMJ - Childhood cancer infographic identifying NICE guidance on referral for cancer (July 2015)
This is a BMJ infographic on child referral guidelines for suspected cancer based on symptoms.
MacMillan Cancer Support Rapid Referral Guidelines
This has been produced by MacMillan based on NICE guidelines with input from MacMillan GPs. This is not a substitute for clinical acumen and should be used as guidance.

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