haematuria - NICE urgent cancer referral guidance

Last reviewed 01/2018

Haematuria

Symptom and Specific Features Possible Cancer Recommendation
Haematuria (visible and unexplained) either without urinary tract infection or that persists or recurs after successful treatment of urinary tract infection, 45 and over Bladder or renal Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks)

Symptom and Specific Features Possible Cancer Recommendation
Haematuria (non-visible and unexplained) with dysuria or raised white cell count on a blood test, 60 and over Bladder Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks)

Symptom and Specific Features Possible Cancer Recommendation
Haematuria (visible) with low haemoglobin levels or thrombocytosis or high blood glucose levels or unexplained vaginal discharge in women 55 and over Endometrial Consider a direct access ultrasound scan

Symptom and Specific Features Possible Cancer Recommendation
Haematuria (visible) in men Prostrate Consider a prostate-specific antigen (PSA) test and digital rectal examination

Note:

  • in 2005 NICE cancer guidance, unexplained microscopica haematuria (non-visible haematuria) in a patient 50 years or over was a 2 week referral. This guidance has not been repeated in the 2015 guidance but local implementation might mean that this guidance may be still employed when a local implementation of the NICE urological guidance is made

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