Suspected cancer: recognition and referral

Lumps or swelling in your abdomen

If you have a lump or swelling in your abdomen, you might be offered an appointment to see a cancer specialist within 2 weeks. Whether or not you are offered this appointment and which type of cancer they will check for will depend on other symptoms you have. For example, if your GP thinks your lump is being caused by a swollen spleen, you might be referred to check for a type of cancer called non‑Hodgkin's lymphoma, but this might depend on other symptoms that you have. If your lump is in the upper part of the abdomen and your GP thinks stomach cancer is possible, then you might be referred to check for this.

If you are a woman and your GP examines your abdomen and finds a lump, and doesn't think it is caused by fibroids (non‑cancerous growths) in your womb, you should be referred to see a specialist within 2 weeks to check for cancer of the ovaries.

If your GP thinks the lump is caused by swelling of both the liver and spleen, you may be offered a blood test to check for leukaemia (cancer of the white blood cells) – this blood test, called a full blood count, should be carried out within 2 days.

If the lump or swelling is just in the upper part of your abdomen, and your GP thinks this might be being caused by an enlarged liver or gall bladder, you may be offered a scan to check for any signs of cancer in these organs. This should be carried out within 2 weeks.

Pain or bloating in your abdomen

You should be offered an appointment with a specialist within 2 weeks to check for cancer of the colon or rectum (parts of your intestine) if you are 40 or over, have pain in your abdomen and have weight loss that can't be explained by anything else. If you have these symptoms but are 60 or over, you might be offered a scan to check for cancer of the pancreas (an important gland that helps digestion and produces insulin) – the scan should take place within 2 weeks. If you are 55 or over with these symptoms but the pain is only in the upper part of your abdomen, you should be offered a procedure (called an endoscopy) within 2 weeks to look inside your throat and stomach for any signs of cancer. You might also be offered this procedure if you have had abnormal blood test results or have been feeling or being sick as well as being in pain.

If you have pain in your abdomen and also have visible bleeding from your bottom, you may be offered an appointment with a specialist within 2 weeks. However, if you have pain but don't have any visible bleeding from your bottom, and you are 50 or over, you should be offered a test to check for traces of blood in your faeces (also called stools) – this can help check for possible cancer of the colon or rectum.

If you are a woman and have pain or bloating in your abdomen that is long‑lasting or happens often (particularly if this happens more than 12 times a month), or you are 50 or over with symptoms of irritable bowel syndrome (which include pain, bloating and changes to bowel movements) that started within the past year, you should be offered a blood test (called a CA125 test) to check for cancer of the ovaries. This test will probably be carried out at your GP surgery, and is particularly important if you are 50 or over.

For more information on tests for blood in your faeces (stools) or a CA125 test see test results.

Indigestion, reflux, feeling or being sick, or vomiting blood

Stomach symptoms, such as reflux (when a feeling of acid burning spreads upwards in the chest), indigestion (also called dyspepsia) or feeling or being sick, are common. However, your GP may want to carry out checks for cancer of the stomach or oesophagus (food pipe) if they don't think your symptoms are caused by something else, and depending on your age and other symptoms you might have.

You should be offered a procedure (called an endoscopy) to look inside your throat and stomach if you are 55 or over, have reflux or indigestion, and you have lost weight – the procedure should be done within 2 weeks. You might also be offered the procedure (although not necessarily within 2 weeks) if you are vomiting blood or you are 55 or over and have any of the following:

If you are 60 or over, have lost weight and you have been feeling sick or being sick, your GP may offer you a scan to check for cancer of the pancreas – this scan should be carried out within 2 weeks.

Problems with your bottom or bowel movements

Changes in your bowel movements include diarrhoea, constipation and other changes to the usual timing, size, amount, consistency and frequency of your bowel movements. These symptoms are common, but you may be referred or offered checks for possible cancer if your GP doesn't think they are caused by anything else, especially if you also have other symptoms or you are 60 or over.

If you are 60 or over and have changes in your bowel movements and your GP doesn't think they are caused by anything else, you should be offered an appointment to see a cancer specialist within 2 weeks to check for cancer of the colon or rectum (parts of your intestine). If the changes to your bowel movements are diarrhoea or constipation and you have also lost weight, you may be offered a scan to check for cancer of the pancreas – this scan should happen within 2 weeks. However, if you are under 60 and your bowel movements have changed, you should be offered a test to check for traces of blood in your faeces (also called stools).

If you are a woman with symptoms of irritable bowel syndrome (which include changes to bowel movements and pain and bloating in the abdomen) that started within the past year and you are 50 or over, you should be offered a blood test (called a CA125 test) to check for cancer of the ovaries. You might also be offered this test if you have changes to your bowel movements, regardless of your age.

If you are 50 or over and have bleeding from your bottom and your GP doesn't think it is caused by anything else, you should be offered an appointment to see a cancer specialist within 2 weeks to check for cancer of the colon or rectum. If you are under 50, you may be offered this appointment if you also have other symptoms, such as pain in your abdomen, changes to your bowel movements, weight loss or anaemia (caused by loss of blood). You might also be offered this appointment if you have a sore or a lump inside your bottom. The appointment might be to check for cancer of the colon or rectum or of the anus, depending on where inside your bottom the symptoms are.

For more information on tests for blood in your faeces (stools) or a CA125 test see test results.