2ww Gynaecology
2ww Gynaecology referral
Clinical ascites and/or a pelvic or abdominal mass (not uterine fibroids)
Ultrasound suggests ovarian cancer
≥55yr + post‑menopausal bleeding (uterine cancer)
<55yr + post‑menopausal bleeding (uterine cancer)
Examination of cervix is consistent with cervical cancer
High-grade dyskaryosis (moderate or severe) —> Referred for colposcopy within 2 weeks.
Suspected invasive cancer or glandular neoplasia —> Referred for colposcopy within 2 weeks.
Unexplained vulval lump, ulceration or bleeding (vulval cancer)
Unexplained palpable mass in or at the entrance to the vagina (vaginal cancer)
Direct access tests in primary care (serum CA125 +/- ultrasound abdomen and pelvis)(ovarian cancer)
≥50yr + frequent (>12/month) abdominal distension/bloatedness; feeling of fullness and/or loss of appetite, pelvic or abdominal pain, increased urinary urgency and/or frequency
≥50yr + new-onset irritable bowel symptoms
Unexplained weight loss, fatigue or changes in bowel habit
If serum CA125 is 35 IU/ml or greater, arrange an ultrasound scan of the abdomen and pelvis.
Direct access tests in primary care (ultrasound abdomen and pelvis)(endometrial cancer)
≥55yr + unexplained vaginal discharge + first presentation discharge/ thrombocytosis/ haematuria
≥55yr + visible haematuria + low haemoglobin/ thrombocytosis/ high blood glucose