Referral to a specialist for symptoms of oesophageal cancer

Your GP should arrange for you to see a specialist if you have symptoms that could be due to oesophageal cancer. Depending on your symptoms and other factors, this might be an urgent suspected cancer referral.

Your GP might also refer you straight to the hospital for a test to look inside your oesophagus (gastroscopy). 

You will see a specialist or have tests as soon as possible. Ask your GP when this is likely to be.

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics or antacid medicine.

You should go back to your GP if your symptoms don't get better, or if they get worse.

UK referral guidelines

There are guidelines for GPs to help them decide who needs a referral. These vary slightly between the different UK nations. Your GP will use these guidelines as well as their own experience and judgement.

In England and Wales

You should have a gastroscopy to look inside your food pipe within 2 weeks if you have difficulty swallowing (dysphagia). 

Or you should have a gastroscopy within 2 weeks if you’re 55 or older, have lost weight and have any of the following symptoms:

• pain in your upper tummy (abdomen)
• heartburn or acid reflux (stomach acid coming back up into the food pipe)
• indigestion (dyspepsia)

The guidelines say that your GP should consider referring you for a non urgent gastroscopy if you’ve been vomiting blood (haematemesis). Depending on your situation, your GP might refer you more urgently.

In Northern Ireland

In Northern Ireland the guidance groups together the symptoms of:

• pancreatic cancer
• cancer of the food pipe (oesophagus)
• stomach cancer
• cancer of the first part of your bowel (duodenum)
• liver cancer
• bile duct cancer
• cancer of the gall bladder

As these are grouped together, some of the symptoms listed below may not relate to oesophageal cancer. But your GP can use guidance like this to help them decide who to refer urgently.

Your GP should refer you urgently for a gastroscopy or to see a specialist if you are any age, have indigestion and any of the following:

• symptoms such as blood in your poo, or your poo is black or tar-looking due to bleeding in your digestive system  
• difficulty swallowing (dysphagia)
• losing weight without trying to
• being sick and this is not getting better
• lack of iron in the body (iron deficiency anaemia) – this is picked up with a blood test
• a lump (mass) in the upper part of your tummy (abdomen)
• an abnormal result from a test called a barium meal

Your GP should refer you urgently for a gastroscopy if you are 55 years or older and you have recently developed indigestion that is unexplained.

Your GP should refer you urgently to see a specialist if you have:

• difficulty swallowing 
• unexplained pain in the upper part of your tummy and weight loss. You may or may not have back pain with this
• a lump in the upper part of your tummy and you do not have indigestion
• a condition called obstructive jaundice. This is when the tube that drains bile from your liver to your small bowel gets blocked. Symptoms include yellowing of the skin or whites of the eyes

Some people with obstructive jaundice will have an urgent ultrasound. Your GP will tell you if this is necessary for you.

Your GP might refer you urgently to see a specialist if you have no sign of indigestion and you are:

• being sick and this is not getting better and you are losing weight
• have unexplained weight loss or have a lack of iron in your body

Your GP might refer you urgently to see a specialist if you have unexplained indigestion that is getting worse and you are known to have:

• Barrett’s oesophagus
• abnormal cells (dysplasia)
• inflammation and thinning of the stomach lining (atrophic gastritis)
• changes to the lining of the food pipe and stomach that looks like the lining of the bowel (intestinal metaplasia)
• had peptic ulcer surgery over 20 years ago

In Scotland

In Scotland, the guidance groups together the symptoms of:

• stomach cancer
• cancer of the food pipe (oesophagus) 

You should have an urgent referral to a specialist if you have difficulty swallowing or painful swallowing. 

Or you should have an urgent referral if you have unexplained weight loss, particularly if you are 55 or over and have one or more of the following:

• upper tummy pain that is new or getting worse
• unexplained low iron levels in your blood (anaemia)
• stomach acid travelling up towards the throat (acid reflux)
• indigestion (dyspepsia) that does not get better with treatment
• vomiting

You should see a specialist if you have vomiting that is new and has continued for more than 2 weeks.

Remember, these symptoms can be caused by other conditions, and do not necessarily mean that you have oesophageal cancer. But it is important to get them checked out.

Non urgent referral

Your GP might refer you for a non urgent gastroscopy, depending on what symptoms you have. There are some non urgent referral guidelines. These vary slightly between the different UK nations. Your GP can tell you more about this.

Other symptoms

Your GP will consider any other symptoms that you are having, so do mention these. They might also take into account whether you have any risk factors that affect your chances of developing oesophageal cancer.

If you are still worried

Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print this page and the symptoms page. Ask your GP to explain why they don’t think you need a referral. 

Contact your GP again if your symptoms don't get better or you notice any new or unusual symptoms.

What should I do if I don't get my appointment?

If your GP has referred you, ask them when you should get your appointment. Contact them again if you don’t get one. Or some hospitals have a referral service you could try contacting if you know which hospital you are going to. Explain that you are waiting for an urgent suspected cancer referral.

Waiting times

Your hospital is working towards waiting time targets. For example, a target to find out whether you have cancer or not. And there are targets to start treatment if you are diagnosed with cancer. These are slightly different depending on where you live in the UK. Unfortunately, due to COVID-19 this may take a bit longer.