Suspected Lung and Pleural Cancers
NICE guideline [NG12] Suspected cancer: recognition and referral. Last updated May 2025.
This article only covers the recognition and referral recommendations of the named cancers. It does NOT cover further information or recommendations with regards to the names cancers.
Terms Used by NICE Guideline
Definitions
| Terms | Description |
|---|---|
| Suspected cancer pathway referral | To receive a diagnosis OR exclusion of cancer within 28 days of being referred |
| Immediate | To occur within a few hours, or even more quickly |
| Very Urgent | To occur within 48 hours |
| Urgent | To occur within 2 weeks |
Lung Cancers
Suspected Cancer Pathway Referral
Refer for an appointment within 2 weeks if:
- >40 y/o + unexplained haemoptysis, OR
- Chest X-ray findings that suggest lung cancer
Offer Urgent Chest X-ray
If >40 y/o AND 2 or more of the following unexplained symptoms OR 1 or more of the following if they have ever smoked:
- Cough
- Fatigue
- Shortness of breath
- Chest pain
- Weight loss
- Appetite loss
Consider Urgent Chest X-ray
If >40 y/o AND any of the following:
- Persistent / recurrent chest infection
- Finger clubbing
- Supraclavicular lymphadenopathy or persistent cervical lymphadenopathy
- Thrombocytosis
- Chest signs consistent with lung cancer
Mesothelioma
Suspected Cancer Pathway Referral
If chest X-ray findings suggest mesothelioma.
Offer Urgent Chest X-ray
If >40 y/o AND 2 or more of the following unexplained symptoms OR 1 or more of the following if they have ever smoked Or 1 or more of the following if they have been exposed to asbestos:
- Cough
- Fatigue
- Shortness of breath
- Chest pain
- Weight loss
- Appetite loss
Consider Urgent Chest X-ray
If >40 y/o AND any of the following:
- Finger clubbing
- Chest signs compatible with pleural disease