Symptom variation from different cancers is vast and there are several red flag symptoms. People should seek medical attention when they have a change in normal function. When assessing people, safety netting should be provided, explaining when and why they should return. Some symptoms that should ring alarm bells are:

  • Worsening breathlessness

  • Persistent cough

  • Unexplained haemoptysis

  • Voice hoarseness

  • Unexplained vaginal bleeding1

  • Post-menopausal bleeding

  • Persistent indigestion

  • Dysphagia

  • Unexplained jaundice

  • Unresolved oral ulcers over 3 weeks

  • Night sweats

  • Breast lumps or changes

  • Abdominal bloating

  • Unexplained weight loss

  • Rectal bleeding

  • Change in bowel habit

  • Haematuria

  • Persistent urinary tract infections

  • Suspicious pigmented skin lesion

  • Urinary urgency and frequency

  • Persistent lump or mass

  • Unexplained pain/ache

  • Persistent and unexplained fatigue

  • Bone pain/swelling

There are some very useful resources to provide support, guidance and practical referral recommendations for general practitioners 

NICE - Suspected cancer: recognition and referral guidelines (June 2015) – this gives healthcare professionals guidance on referral recommendations based on cancer by site of origin. There are some new suggestions that have been added in 2015.

BMJ - Adult cancer infographic identifying NICE guidance on referral for cancer (July 2015) – this is an easy-to-use and colourful infographic on adult referral guidelines for suspected cancer based on symptoms produced by BMJ.

BMJ - Childhood cancer infographic identifying NICE guidance on referral for cancer (July 2015) – this is a BMJ infographic on child referral guidelines for suspected cancer based on symptoms.

MacMillan Cancer Support Rapid Referral Guidelines – this has been produced by MacMillan based on NICE guidelines with input from MacMillan GPs. This is not a substitute for clinical acumen and should be used as guidance.