Rapid Cancer Diagnostic Service referrals (previously ECDC)

This pathway is open to all patients aged 18 years or older who meet the referral criteria listed below who are not suitable for pre-existing site specific Urgent Suspicion of Cancer pathways.

Consider referral via this pathway for:

• Unexplained weight loss - documented 5% or more in 3 months or a strong clinical suspicion
• New, unexplained loss of appetite, fatigue nausea, malaise or bloating for 4 weeks or more
• New unexplained pain (abdominal /back/bone) for 4 weeks or more 
• New unexplained laboratory results eg hypocalcaemia or thrombocytopenia
• GP – ‘gut feeling’ of cancer diagnosis

Inclusion criteria:

• There is no other urgent suspicion of cancer referral pathway for this clinical scenario
• Patient is well enough to attend as an outpatient and does not need admission
• All the mandatory filter tests listed below have been done
• Able and willing to attend an all day diagnostic clinic at short notice

If any of the above answers are no, the patient is not suitable for this pathway

The ECDC pathway is not suitable for:

• Patients already on Site Specific Cancer Pathway
• Symptoms most likely related to a recurrent cancer
• Patients previously seen in the ECDC within the last 3 months with no new symptoms
• Patients who have a CT CAP within the last 3 months showing no suspicion of malignancy
• A serious non-cancer diagnosis is suspected
• Temporary residents*

*although temporary residents are excluded from the pathway we are aware that temporary can actually mean semi-permanent in some case so please e-mail us at the address above to discuss if you want to refer a temporary resident.

Referrals are made via SCI Gateway...DGRI...Clinical Oncology...DG-HN ECDC Referral

All patients must have the following suite of pre-referral tests done with results available before referral. There is an OrderComs bundle available called ECDC Referral Tests to make it easier to request (just make sure to deselect PSA or CA125 as appropriate)

• Urinalysis
• FBC
• ESR
• CRP
• LFT
• TFT
• HbA1c (if HbA1c is newly raised please request faecal elastase)
• Bone biochem
• PSA (men)
• CA-125 (women)
• FIT test (using FIT test sample kit)
• Ferritin and Iron studies
• Pregnancy test (all females of child bearing age)
• HIV serology

Additional comments section

Please include results of all the mandatory examinations and any other relevant information in this section. This information will be used to determine the patient’s eligibility for this pathway so please include all relevant information in this section.

Referrer gut feeling of cancer

Please complete this section with as much information as possible relating to the patients presentation. This information will be used during the triage process to determine if the patient is eligible for this referral pathway.

Preferred contact method

Please ensure the telephone number is completed and the patient is aware they will be phoned from a 0800 telephone number to arrange a clinic appointment.

Please ensure you give the patient the ECDC information leaflet and the patient is aware they have been referred on a suspicion of cancer pathway.