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Non-specific symptoms pathway (VAGUE) for referring cancer patients

The non-specific symptoms (NSS) pathway provides a route for patients presenting with vague symptoms who may have a serious illness.

VAGUE symptoms

 Patients who present with vague (non-specific) symptoms could have a serious disease or a cancer. If patients have weight loss (>5%), non-specific abdominal pain, fatigue or loss of appetite, consider an NSS pathway referral.

 A full clinical examination and history taking may suggest a specific concern. Arrange for a face-to-face review to rule out any tumour-specific/acute presentation.

 Refer to the guidance. The NICE guidance (NG 12) provides advice and information on the cancer referral pathways, including NSS.

 Undertake filter function tests, including a chest X-ray, FIT tests and bloods, to rule out whether a site-specific pathway would be more appropriate. Filter function tests should be carried out and reviewed before referral.

 Make an electronic referral to the Faster Diagnostic Team. Ensure you use the correct referral form and attach a full patient summary.

Gut feeling

If you have a gut feeling that a patient has a serious underlying condition, make the referral or speak to one of the team's clinicians.



Last reviewed: 24 July 2023