[Strong recommendation] Use a suspected cancer pathway referral for adults with chest X-ray findings suggestive of lung cancer OR adults aged 40+ with unexplained haemoptysis.
[Strong recommendation] Offer an urgent chest X-ray (within 2 weeks) to adults aged 40+ with 2+ unexplained symptoms (cough, fatigue, shortness of breath, chest pain, weight loss, appetite loss) OR those with any smoking history and 1+ such symptom.
[Moderate recommendation] Consider an urgent chest X-ray (within 2 weeks) for adults aged 40+ with persistent/recurrent chest infection, finger clubbing, supraclavicular/persistent cervical lymphadenopathy, chest signs suggesting lung cancer, or thrombocytosis.
[Moderate recommendation] Consider PSA testing and digital rectal examination for individuals with lower urinary tract symptoms, erectile dysfunction, or visible haematuria.
[Conditional recommendation] Consider a suspected cancer pathway referral for individuals with symptoms as per 1.6.2 if their PSA exceeds age-specific thresholds, taking into account patient preferences and comorbidities.
[Strong recommendation] Offer FIT using specified tests to adults with an abdominal mass, change in bowel habit, iron-deficiency anaemia, or specific age-symptom combinations (e.g., 40+ with weight loss and abdominal pain, 50+ with rectal bleeding/abdominal pain/weight loss, 60+ with anaemia).
[Moderate recommendation] Consider non-urgent referral for individuals under 30 with an unexplained breast lump with or without pain, and refer to specialist advice recommendations if uncertain.
[Conditional recommendation] Consider referral for children if parents/carers have persistent concern or anxiety about symptoms, even if benign cause is likely, taking into account their insight and knowledge.
[Moderate recommendation] Consider a suspected cancer pathway referral for these patients. [Very Low evidence] Based on very uncertain evidence from studies in referred populations.
[Moderate recommendation] Consider a direct access ultrasound scan. [Expert Opinion] Based on NICE guideline consensus and evidence review.
[Moderate recommendation] Consider an urgent, direct access CT scan within 2 weeks, or an urgent ultrasound if CT is unavailable. [Expert Opinion] Based on NICE guideline consensus.
[Strong recommendation] Refer them using a suspected cancer pathway. [Expert Opinion] Based on NICE guideline consensus.
[Moderate recommendation] Arrange an ultrasound scan of the abdomen and pelvis. [Expert Opinion] Based on NICE guideline consensus.