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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.
REFERRAL GUIDELINES FOR SUSPECTED GYNAECOLOGICAL CANCER (All patients will be seen within 2 weeks of referral
A full pelvic examination, including speculum examination of the cervix, is recommended for patients presenting with any of the following:
Ovarian cancer is difficult to diagnose. In patients with vague, non-specific, unexplained abdominal symptoms such as:
Carry out an abdominal examination and pelvic examination, request Ca 125 levels, and consider referral for urgent TA/TV pelvic US examination.
In suspected cervical cancer, on examination, a smear test is not required before referral and a previous negative smear should not defer referral
In patients with vulval pruritus or pain, a period of "treat, watch and wait" is reasonable. Active follow-up is recommended until symptoms resolve or a diagnosis is confirmed. If symptoms persist, the referral may be urgent or non-urgent, depending on the symptoms and the degree of concern about cancer.
Please refer to:
IF PATIENT IS UNSURE WHERE BLOOD IS ORIGINATING, PLEASE PERFORM CLINICAL EXAMINATION TO CLARIFY WHETHER GYNAECOLOGY OR COLORECTAL PATHWAY MAY BE MORE APPROPRIATE