Patient

Age (years)

Reproductive organs

Has ever smoked Asbestos exposure

Symptoms & signs

Find a symptom

Nothing ticked yet.

Results & investigations

FIT (µg Hb/g faeces)

CA125 (IU/mL)

PSA (µg/L)

Weight lost in 6 months (%)

Pigmented skin lesion – 7-point checklist

7-point score: 0

NICE-recommended actions

Enter age and tick symptoms, signs or results to see the NICE actions.

Decision support only, based on NICE NG12 (15 April 2026). 'Unexplained' means not explained after initial assessment, including history, examination and primary care tests. Many symptoms here need clinical judgement and some (e.g. acute haematemesis, cord compression, neutropenic sepsis) need emergency care regardless. Local pathways and referral forms apply.

Quick reference

Action levels & definitions

Immediatean acute admission or referral within a few hours
Very urgent (48 h)referral or test within 48 hours
Refer – suspected cancer pathwayreferral so that cancer is diagnosed or ruled out within the national Faster Diagnosis Standard
Consider suspected cancer pathway"consider" – use clinical judgement
Urgent direct access testGP-requested test performed within 2 weeks
Primary care teststests to carry out before deciding on referral
Assessassess for other features, then urgent investigation, a suspected cancer pathway or non-specific symptoms pathway referral
Non-urgentroutine referral or test

"Unexplained" = not explained by the clinician after initial assessment, including history, examination and primary care tests. Children and young people = aged 24 and under. Make referrals within 1 working day of the decision (1.16.8).

Thresholds (FIT, CA125, PSA)

Test	Threshold	Action
FIT	≥10 µg Hb/g	Suspected cancer pathway (colorectal) (1.3.2)
CA125 age 40–49	≥35 IU/mL	Urgent direct access abdominal and pelvic ultrasound (1.5.9). Under 40: don't use CA125 alone – consider urgent ultrasound (1.5.6)
CA125 age 50–59	≥31
CA125 age 60–69	≥24
CA125 age 70–79	≥25
CA125 age 80+	≥31
PSA age 40–49	>2.5 µg/L	Consider suspected cancer pathway (prostate), taking account of preferences and comorbidities (1.6.3). Under 40 or over 79: clinical judgement
PSA age 50–59	>3.5
PSA age 60–69	>4.5
PSA age 70–79	>6.5

Browse all recommendations by cancer site

What changed in April 2026

Ovarian: age-banded CA125 thresholds from 40; under 40 – ultrasound rather than CA125 alone
Endometrial: post-menopausal bleeding not attributable to HRT – refer at 55+, consider under 55. Unscheduled bleeding on HRT – follow British Menopause Society guidance (1.5.15)
Unexplained weight loss at 60+ (>5% in 6 months), unexplained appetite loss and DVT – assess, then urgent investigation, suspected cancer pathway or non-specific symptoms pathway (1.13.2–1.13.4)
Earlier in 2025: myeloma blood tests updated (serum free light chains); oesophageal/stomach symptoms moved to suspected cancer pathway referral rather than direct access endoscopy

Patient information & leaflet

Explain that most people referred don't have cancer; discuss other possible diagnoses (1.14.1–1.14.2)
Give information on where, when, tests, results timing, bringing someone, and who to contact (1.14.3)
Safety-netting: explain which symptoms to watch for and when to return; written information helps (1.14.5–1.14.6)

Why have I been referred?

You have been referred on an urgent suspected cancer pathway because your symptoms or test results need to be checked quickly. This is a precaution. Most people referred this way do not have cancer. Your symptoms may well have another cause, and the tests will help find out.

If cancer is found, finding it early gives the best chance of successful treatment, which is why this pathway is fast.

What happens next?

The hospital will contact you, usually within a few days, to arrange an appointment or test. This may be a clinic visit, a scan, a camera test (endoscopy) or a phone call first.

The NHS aims to tell you whether or not you have cancer within 28 days of your referral.

You may have more than one test, and some may be booked directly without a clinic appointment first.

You can bring a family member or friend with you to appointments.

What you can do

Make sure we have your correct phone number and address. Hospitals often phone from withheld numbers, so answer unknown calls if you can.

Keep yourself available for appointments over the next few weeks. If you are going away, tell your GP practice before the referral is sent.

Go to all your appointments. If you really cannot attend, contact the hospital straight away to rebook.

Write down any questions you want to ask.

If you take blood thinners or diabetes medicines, the hospital may give you instructions before some tests.

If you have not heard from the hospital within the time you were told (usually about a week), contact the hospital or your GP practice using the details above.

While you wait

Waiting can be worrying, and it is normal to feel anxious. Talk to someone you trust, and contact your GP practice if you need support. You can carry on with your usual activities unless you have been told otherwise.

When to get help sooner

Contact your GP practice the same day, or call 111, if your symptoms get worse or you develop new symptoms, such as worsening pain, bleeding, being sick, yellowing of your skin or eyes, or losing weight quickly.

Call 999 or go to A&E if you are vomiting blood or passing black stools, have severe pain, sudden weakness or numbness, difficulty breathing, or feel very unwell.

If you were not referred

Sometimes your clinician will decide to keep a close eye on your symptoms instead of referring you. That means your risk is low at the moment. Come back if your symptoms do not settle, get worse, or you notice anything new. Your clinician will tell you which symptoms to look out for and when to return.

Where to find more help

NHS – urgent cancer referral: nhs.uk/conditions/cancer

Macmillan Cancer Support (free support line 0808 808 00 00): macmillan.org.uk

Cancer Research UK nurses (0808 800 4040): cancerresearchuk.org

Maggie's (free centres and online support): maggies.org

Based on NICE guideline NG12, Suspected cancer: recognition and referral (updated April 2026). This leaflet is general information and does not replace advice from your own healthcare team.

NICE Suspected Cancer Referral