№ lp_2_1_08761
Standardised NHS urgent suspected cancer referral form for adults presenting with non-specific but concerning symptoms requiring triage, diagnostic testing, and potential further investigation within a fast track pathway.
Document Type: Referral pro-forma
Clinical Pathway: Non-Specific Symptoms (NSS) Pathway
Purpose: Urgent suspected cancer referral
Referral Method: e-Referral Service (eRS)
Applicable Age Group: 18 years and over
Guideline Reference: NICE Guideline NG12 Recognition and Referral of Suspected Cancer
Healthcare Setting: Primary Care and Secondary Care Interface
Receiving Institution: Sheffield Teaching Hospitals
Sections: Patient Details; Registered GP Details; Patient Engagement; Clinical Information; Essential Pre-Referral Tests; Performance Status (WHO Classification)
Mandatory Pre-Referral Tests: FBC; CT CAP; U&Es with eGFR; LFTs including calcium; Bone Profile; TFT; CRP and/or ESR; HbA1c and Glucose; Ferritin; CA125 (Female); PSA (Male); Chest X-Ray (if indicated); Symptomatic FIT Test
Exclusion Criteria: Haematuria; Post-menopausal bleeding; Abnormal vaginal bleeding; Haemoptysis; Cough; Melaena; Rectal bleeding; Haematemesis; Dysphagia
Performance Status Scale: WHO 0–4
Final Diagnosis Categories: Malignant; Benign
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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