Referral to a specialist for symptoms of lung cancer

Your GP should arrange for you to see a specialist or have tests if you have symptoms that could be due to lung cancer. Depending on your symptoms and other factors, this might be an urgent referral.

You will see a specialist or have tests as soon as possible. Ask your GP when this is likely to be.

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

Your GP might arrange for you to have some tests first. This will help them decide if you need to see a specialist.

UK referral guidelines

There are guidelines for GPs to help them decide who needs a referral. These vary slightly between the different UK nations. Your GP will use these guidelines as well as their own experience and judgement.

England and Wales

You should get an urgent appointment for an x-ray (within 2 weeks) if you are over 40 and have 2 or more of these symptoms or if you have ever smoked, or have had previous exposure to asbestos and have 1 or more of these symptoms:

a cough most of the time, including coughing up blood for no reason
tiredness and weakness (fatigue)
shortness of breath
chest pain
weight loss
loss of appetite

Your GP should consider referring you for an urgent chest x-ray (within 2 weeks) if you are over 40 and have any of these:

an ongoing or recurrent chest infection
a particular type of thickening and broadening of the fingertips, called finger clubbing
swollen (enlarged) lymph nodes in your neck or above your collarbone
chest symptoms such as a cough, shortness of breath or chest pain
a high platelet count in your blood (thrombocytosis)

You should have an urgent referral to see a specialist if you:

have a chest x-ray that shows changes that could be due to lung cancer
are aged 40 or over and are coughing up blood

Scotland

Your GP should refer you for an urgent x-ray of the chest if you have any of the following symptoms:

coughing up blood for no reason
a new or not noticed before thickening and broadening of the fingertips, called finger clubbing
an ongoing or recurrent chest infection
enlarged lymph nodes in your neck or above your collarbone
a high platelet count in your blood (thrombocytosis), and signs do not suggest another type of cancer

You should also get an urgent chest x-ray if you have had any of the following symptoms for more than 3 weeks and there is no obvious cause:

changes in a cough or a new cough
difficulty breathing
chest or shoulder pain
loss of appetite
weight loss
chest signs
hoarseness
tiredness and weakness (fatigue) if you’re a smoker aged over 40 years

If certain changes have been picked up on your x-ray (a white area, that can be caused by several things, also called consolidation), you should have a further x-ray no more than 6 weeks later to show that it has cleared up.

Your GP should refer you urgently to a specialist if you:

have any of the symptoms above for longer than 6 weeks despite having a normal chest x-ray
have a chest x-ray that has changes that could be due to lung cancer
are aged 40 or over, are a smoker or ex smoker and you are coughing up blood

Northern Ireland

Your GP should refer you immediately if you have:

swelling of the face or neck - this could be a sign of a blockage of a large vein to the heart (superior vena cava obstruction)
noisy breathing caused by a blockage or narrowing of the airway (stridor)

Your GP should refer you for an urgent chest x-ray if you:

cough up blood
have an underlying chronic breathing problem with unexplained changes in symptoms

You should also get an urgent chest x-ray if you have any of the following symptoms for more than 3 weeks or there is no obvious cause:

chest or shoulder pain
difficulty breathing
weight loss
chest signs
hoarseness
a type of thickening and broadening of the fingertips, called finger clubbing
enlarged lymph nodes in your neck or above your collarbone
a cough

Your GP should refer you urgently to a specialist if you:

are a smoker or ex smoker aged 40 years or older and are coughing up blood and it’s not getting better (persistent haemoptysis)
have had a chest x-ray that shows you might have lung cancer
have had a normal chest x-ray but your GP thinks you might have lung cancer
have a history of being in contact with asbestos and recently started to have chest pain, or shortness of breath, or unexplained symptoms and have an abnormal x-ray

Other symptoms

Your GP will consider any other symptoms that you are having, so do mention these. They might also take into account whether you have any risk factors that affect your chances of developing lung cancer.

What should I do if I don’t get my appointment?

If your GP has referred you, ask them when you should get your appointment. Contact them again if you don’t get one. Or some hospitals have a referral service you could try contacting if you know which hospital you are going to. Explain that you are waiting for an urgent suspected cancer referral

Waiting times

Your hospital is working towards waiting time targets. For example, a target to find out whether you have cancer or not. And there are targets to start treatment if you are diagnosed with cancer. These are slightly different depending on where you live in the UK.