Last reviewed: 22 April 2025
Last reviewed: 22 April 2025
NICE NG12 (2015) include recommendations for managing those with certain non-specific symptoms:
For people with unexplained weight loss (which is a symptom of several cancers including colorectal, gastro‑oesophageal, lung, prostate, pancreatic and urological cancer)
For people with unexplained appetite loss (which is a symptom of several cancers including lung, oesophageal, stomach, colorectal, pancreatic, bladder and renal cancer)
For people with deep vein thrombosis, (which is associated with several cancers including urogenital, breast, colorectal and lung cancer):
carry out an assessment for additional symptoms, signs or findings that may help to clarify which cancer is most likely and
offer urgent investigation or a suspected cancer pathway referral.
In Wales, RDCs aim to support the diagnosis of adults who don’t clearly fit into a single USC referral pathway, but who are at risk of being diagnosed with cancer. In areas where RDCs aren't available, GPs should check their local pathways.
NHS Wales recommends the below inclusion criteria for RDCs:
People aged 18 years and over
People who present with non-site-specific symptoms such as unexplained weight loss, severe unexplained fatigue, persistent nausea and/or appetite loss, new atypical pain e.g. abdominal or bone pain
Unexplained abnormal blood tests - eg anaemia, hypercalcaemia, thrombocytosis
Where the GP has a ‘gut feeling’ that there is serious underlying disease that is likely to be due to occult malignancy
Patient is well enough, willing, and able to go through the process and attend the clinic day
GP has requested ‘Set A’ bloods at the time of referral
Patient is not suitable for any site-specific urgent pathway
A national evaluation of the services is underway.
