Suspected cancer: recognition and referral

In April 2025, we reviewed this guideline in response to a series of NHS England National cancer programme reviews that looked at opportunities for earlier diagnosis, including for myeloma.

Surveillance decision

We decided to update the section on myeloma to include serum protein electrophesis and serum free light chain testing in the initial diagnostic blood tests. We also recommended that, if available, serum free light chain testing should be offered or considered instead of Bence–Jones urine testing.