Childhood Suspected Cancer Care Pathway

Review in progress

Disclaimer: The guidance contains helpful primary care information for management of referrals and up to date referral criteria. These guidelines are locality specific to best reflect local services. This guidance does not override or replace the individual responsibility of healthcare and social care professionals involved in the delivery of care to make informed professional judgements appropriate to the circumstances of the individual.



  • Refer a child under the age of 16 who presents with symptoms suggesting cancer as detailed in the NICE guidance below.
  • For all suspected Childhood Cancer please speak to the On-Call Paediatric Consultant in the first instance - through the Operations Centre on 01924 543995
  • If you have concerns about a patient's symptoms and /or signs, consider a discussion with the Paediatrician on call.


Please refer to NICE referral guidelines for suspected cancer :

Please speak to the On-Call Paediatric Consultant to seek advice prior to arranging any tests to avoid unnecessary or repeat testing which may prove distressing for the child


The On -Call Consultant may advise the following tests in line with NICE guidance or may opt to see the child in the first instance and then organize relevant tests themselves.

  • Ultrasound if:
    • Soft tissue lump – unexplained and growing
  • Full blood count if:
    • Generalized lymphadenopathy
    • Unexplained bleeding / pallor / bruising
    • Persistent fatigue
    • Unexplained fever
    • Explained persistent infection
    • Unexplained persistent bone pain
  • X-ray if:
    • Bone swelling / unexplained bone pain


Referral Criteria

  • Always discuss with the local paediatrician on call and refer the child/young person to the paediatric department for an appointment within 48 hours
  • If agreed with paediatrician that immediate/48hour assessment not needed refer via 2ww referral
  • Refer children and young people for IMMEDIATE SPECIALIST ASSESSMENT for leukaemia if they have:
    • unexplained petechiae or hepatosplenomegaly or
    • if the results of a full blood count are suggestive of leukaemia
  • Parental concern - Taken into account insight and knowledge of parents and carers when considering making a referral for suspected cancer

Referral Requirements

Referral Instructions

  • If Referral advised by Paediatrician this should be made via eRS
  • Please identify speciality and clinic
  • Out of hours contact the on call paediatrician via the operations centre on 09124 543995

Supporting Information

Assurance & Governance

  • This guidance was developed on: 08.2017
  • This guidance was ratified by: OSCAR Assurance Group
  • Date ratified: 10.2017
  • Publication Date: 12.2017
  • Review Date: 08.2019
  • Ref No:CA13 – 08.2017
Any feedback or suggestions to improve this guidance should be sent to:
Only the electronic version is maintained, once printed this is no longer a controlled document


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