Scottish referral guidelines for suspected cancer: quick reference guide

Lower Gastrointestinal Cancers

High Risk Features:

• Persistent rectal bleeding without anal symptoms.
• Persistent change in bowel habit (>6 weeks), especially to looser stools.
• Right sided abdominal mass.
• Palpable rectal mass.
• Unexplained iron deficiency anaemia.
• Significant family history (see section on assessing genetic risk).

"Watch and wait" is appropriate for patients under 40 with low risk features and particularly those with transient symptoms lasting less than six weeks.