Suspected cancer: recognition and referral

Problems with urinating or blood in your urine

Problems with urinating include pain when you urinate, feeling a sudden need to urinate or needing to urinate more often than usual, finding it difficult to start urinating or not being able to empty your bladder fully, and needing to urinate more often during the night. These symptoms are common and may be caused by a number of other things, but you may be offered checks for possible cancer if your GP doesn't think they are caused by anything else.

If you are 45 or over, have visible blood in your urine and you don't have a urinary infection or you have had an infection but the bleeding continues after it is treated, you should be offered an appointment to see a cancer specialist within 2 weeks to check for kidney or bladder cancer. You should also be offered this appointment to check for bladder cancer if you are 60 or over, tests show that you have traces of blood in your urine and you have either pain when you urinate or blood test results that are abnormal.

If you are a woman aged 55 or over with visible blood in your urine and either a vaginal discharge that your GP doesn't think is caused by anything else or blood test results that are abnormal, your GP may offer you a scan to check for endometrial cancer (cancer of the lining of the womb).

If you are a woman and you find that you are needing to urinate more often than usual or you have a sudden need to urinate, and these symptoms are long‑lasting or happen often (particularly if this happens more than 12 times a month), 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.

If you are a man with urinary problems or visible blood in your urine, you may be offered a blood test (called a prostate-specific antigen test or PSA test for short) and a rectal examination to check for prostate cancer.

For more information on PSA and CA125 tests see test results.

Lumps or pain in your pelvis

If you are a woman and your GP examines your pelvis and finds a lump, and doesn't think it is caused by fibroids (non‑cancerous growths) in your womb, you should be offered an appointment to see a cancer specialist within 2 weeks to check for cancer of the ovaries. If you have pain in your pelvic area (below your belly button) that happens often or is long‑lasting, you should be offered a blood test (called a CA125 test) to check for cancer of the ovaries. For more information see test results.

Lumps in your groin

If you have lumps caused by swollen glands in your groin and your GP doesn't think they are caused by another problem, you may be offered an appointment to see a cancer specialist within 2 weeks to check for lymphoma. This is a cancer of the lymphatic system, which includes things like lymph glands throughout your body that help to fight infection. Your GP will also check if you also have other symptoms of lymphoma, such as fever, night sweats, shortness of breath, itchy skin, weight loss or pain in your glands when you drink alcohol.

If you also have swollen lymph glands in other areas of your body as well as in your groin, you may be offered a blood test to check for leukaemia (cancer of the white blood cells) – this should be done within 2 days.

Problems with your vagina, vulva or cervix

If you are 55 or over and you have vaginal bleeding that happens more than 12 months after the menopause, your GP should offer you an appointment to see a cancer specialist within 2 weeks to check for endometrial cancer (cancer of the lining of the womb). If you are under 55 with these symptoms you might also be offered this appointment.

If you are 55 or over and have vaginal discharge that your GP doesn't think is caused by anything else, and it is a new symptom or you also have abnormal blood test results or visible blood in your urine, your GP may organise a scan for you to check for endometrial cancer.

If you have a lump in or at the entrance to your vagina, or a lump or sore on your vulva (the outer parts of women's genitals), or bleeding from your vulva and your GP doesn't think it is caused by anything else, you may be offered an appointment to see a cancer specialist within 2 weeks to check for cancer of the vagina or vulva.

If your GP examines your cervix (the entrance to the womb from the vagina) and thinks that cancer might be possible, you may be offered an appointment to see a cancer specialist within 2 weeks.

Problems with your penis, testicles or getting an erection

If you have a lump or sore on your penis that isn't caused by a sexually transmitted infection or that continues after treatment for a sexually transmitted infection, you should be offered an appointment to see a cancer specialist within 2 weeks to check for cancer of the penis. You might also be offered this appointment if the end of your penis or foreskin is sore or swollen and your GP doesn't think it is caused by anything else or your symptoms are long‑lasting.

If your testicles are swollen or if they have changed in shape or how they feel, but aren't painful, you should be offered an appointment to see a cancer specialist within 2 weeks to check for cancer of the testicles. If you have other changes to your testicles, and your GP doesn't think they are caused by anything else or your symptoms are long‑lasting, you may be offered a scan to check for cancer.

If you have problems getting an erection, you may be offered a blood test (called a prostate-specific antigen test or PSA test for short) and a rectal examination to check for prostate cancer. For more information see test results.