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Suspected Lung and Pleural Cancers

NICE guideline [NG12] Suspected cancer: recognition and referral. Last updated May 2025. This article only covers the recognition and referral recommendations of the named cancers. It does NOT cover further information or recommendations with regards to the names cancers.

Terms Used by NICE Guideline

Terms	Description
Suspected cancer pathway referral	To receive a diagnosis OR exclusion of cancer within 28 days of being referred
Immediate	To occur within a few hours, or even more quickly
Very Urgent	To occur within 48 hours
Urgent	To occur within 2 weeks

Lung Cancers

>40 y/o + unexplained haemoptysis, OR
Chest X-ray findings that suggest lung cancer

If >40 y/o AND 2 or more of the following unexplained symptoms OR 1 or more of the following if they have ever smoked:

Cough
Fatigue
Shortness of breath
Chest pain
Weight loss
Appetite loss

If >40 y/o AND any of the following:

Persistent / recurrent chest infection
Finger clubbing
Supraclavicular lymphadenopathy or persistent cervical lymphadenopathy
Thrombocytosis
Chest signs consistent with lung cancer

Mesothelioma

If chest X-ray findings suggest mesothelioma.

If >40 y/o AND 2 or more of the following unexplained symptoms OR 1 or more of the following if they have ever smoked Or 1 or more of the following if they have been exposed to asbestos:

Cough
Fatigue
Shortness of breath
Chest pain
Weight loss
Appetite loss

If >40 y/o AND any of the following:

Finger clubbing
Chest signs compatible with pleural disease

References

NICE Suspected cancer: recognition and referral

Author: Adams Lau
Reviewer:
Last edited: 06/05/25

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