Gynaecological Cancer

Definition/Description

These forms are only to be used for referrals with a high risk of cancer.  To assist you in evaluating the potential risk for cancer the QCancer assessment can be beneficial. QCancer has been developed for the UK with risk algorithms.  This tool will only provide a level of risk of cancer and is not a diagnosis tool.

Red Flag Symptoms

No Red Flags listed

Guidelines on Management

Our commissioned acute providers have asked that you bear in mind when sending in a 2 week wait referral to check:

  1. Has it been explained to the patient that this referral is for investigations that could lead to a cancer diagnosis?
  2. Have you checked that the patient will be available in the next 14 days to attend an appointment?
  3. Have you provided the patient with further information about the appointment? A leaflet is available in additional documents
  4. Check patient’s contact details are up to date

Referral Criteria/Information

Suspected Gynaecological cancer - Refer urgently 2WW fast track (suspected cancer ) in women

  • with  ascites and/or a pelvic or abdominal mass (which is not obviously uterine fibroids)
  • where ultrasound suggests ovarian cancer
  • aged ≥ 55  with post-menopausal bleeding (unexplained vaginal bleeding more than 12 months after menstruation has stopped because of the menopause)
  • where the appearance of their cervix is consistent with cervical cancer
  • with an unexplained vulval lump, ulceration or bleeding
  • with an unexplained palpable mass in or at the entrance to the vagina

Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for endometrial cancer in women

  • aged ≤ 55 with post-menopausal bleeding

Make a direct access ultrasound scan to assess for endometrial cancer in women (Marked Urgent PMB)

  • aged ≥ 55 -with unexplained symptoms of vaginal discharge who:
  • are presenting with these symptoms for the first time or
  • have thrombocytosis or
  • report haematuria.

The correct pathway will be selected from the scan results.  If results are clear patient and GP will be informed and care transfered back to Primary Care.

Consider a direct access ultrasound scan to assess for endometrial cancer in women

  • aged < 55 with  visible haematuria and:
  • low haemoglobin levels or
  • thrombocytosis or
  • high blood glucose levels

Carry out tests in primary care if a woman (especially if 50 or over) reports having any of the following symptoms on a persistent or frequent basis – particularly more than 12 times per month:

  • persistent abdominal distension (women often refer to this as ‘bloating’)
  • feeling full (early satiety) and/or loss of appetite
  • pelvic or abdominal pain
  • increased urinary urgency and/or frequency

Measure serum CA125 in primary care in women with symptoms that suggest ovarian cancer.

If serum CA125 is 35 IU/ml or greater, arrange an ultrasound scan of the abdomen and pelvis

For any woman who has normal serum CA125 (less than 35 IU/ml), or CA125 of 35 IU/ml or greater but a normal ultrasound:

  • assess her carefully for other clinical causes of her symptoms and investigate if appropriate
  • if no other clinical cause is apparent, advise her to return to her GP if her symptoms become more frequent and/or persistent

Urgent, low risk of malignancy referral information can be found here.

 

Please complete all referral forms sections in NHS e-Referals Service under 2 week wait (speciality) and 2ww gynaecological (clinic type).  Read code enabled forms are available within the GP system.

The Central Referral Point telephone number is: 01482 604308

Electronic referrals can be made via the NHS e-Referal system. Services for a 2 week wait, suspected cancer are found by searching on speciality for 2ww and then selecting the clinic type i.e. 2ww Gynaecological.

Associated Policies

There are no associated policies.

Specialties

There are no associated specialties.

Places covered by

  • East Riding
  • Hull
  • North East Lincolnshire
  • North Lincolnshire

Hospital Trusts

  • Hull University Teaching Hospitals
Author:
Date created: 26/06/2025, 13:40
Last modified: 30/06/2025, 13:52
Date of review: