Differential diagnosis

Further management

NICE cancer referral guidelines for colorectal cancer suggest the following:


Refer adults using a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer if:
  • they are aged 40 and over with unexplained weight loss and abdominal pain or
  • they are aged 50 and over with unexplained rectal bleeding or
  • they are aged 60 and over with:
    • iron‑deficiency anaemia or
    • changes in their bowel habit, or
  • tests show occult blood in their faeces.

Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer in adults with a rectal or abdominal mass.

Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer in adults aged under 50 with rectal bleeding and any of the following unexplained symptoms or findings:
  • abdominal pain
  • change in bowel habit
  • weight loss
  • iron‑deficiency anaemia.