Department of health higher risk criteria
| Criteria | Elements of the criteria | |
|---|---|---|
| It was recommended that these age/symptom/sign profiles when they were new and persistent should be used to identify patients for prompt referral on the basis of the two week standard. It was estimated that these higher risk criteria would identify 85–90% of all patients with bowel cancer presenting to the outpatient department. | ||
| *Anal symptoms include soreness, discomfort, itching, lumps, and prolapse, as well as pain. | ||
| 1 | Rectal bleeding with a change in bowel habit to looser stools and/or increased frequency of defecation persistent for 6 weeks. All ages | (i) Correct change in bowel habit |
| (ii) Rectal bleeding | ||
| (iii) Symptoms present for at least 6 weeks | ||
| (iv) New symptoms; history not exceeding 18 months | ||
| 2 | Change in bowel habit as above without rectal bleeding and persistent for 6 weeks. Over 60 y | (i) Correct change in bowel habit |
| (ii) Rectal bleeding not present | ||
| (iii) Age ⩾60 y | ||
| (iv) Symptoms present for at least 6 weeks | ||
| (v) New symptoms; history not exceeding 18 months | ||
| 3 | Rectal bleeding persistently without anal symptoms.* Over 60 y | (i) Rectal bleeding |
| (ii) Change in bowel habit not present | ||
| (iii) No perianal symptoms | ||
| (iv) Age ⩾60 y | ||
| (v) Symptoms present for at least 4 weeks | ||
| (vi) New symptoms; history not exceeding 18 months | ||
| 4 | A definite palpable right sided abdominal mass. All ages | (i) Right sided abdominal mass |
| 5 | A definite palpable rectal mass (not pelvic). All ages | (i) Intralumenal rectal mass (not pelvic) |
| 6 | Unexplained iron deficiency anaemia All ages for men, postmenopausal women | Women over 50 y (postmenopausal), haemoglobin ⩽10 g; men: haemoglobin ⩽11 g |