Cancer: Four red flags that are ‘often not urgently referred’ – seen in up to 90% of cases

Bowel cancer: Dr Philippa Kaye lists the symptoms

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Cancer symptoms are often non-specific and vague, which can lead to months of waiting before a referral is made by a doctor. But raised awareness among the population could encourage more patients to come forward for inspection. According to one study, many of the red flag symptoms are often “not urgently” referred by doctors. Four of these, are seen in a large number of cancer patients.

In one 2021 study, researchers found that among patients who reported red flag symptoms suggestive of possible cancer to their GPs, 60 percent were being referred for urgent investigation within two weeks.

Doctor Bianca Wiering, from the University of Exeter Medical School, led the analysis with her team.

She said: “We think this could be improved by stricter adherence to the guideline and increased awareness of the groups of patients in whom symptoms are frequently missed, including younger patients.”

The researchers made the discovery while studying the medical records of nearly 49,000 patients who visited their doctor with alarming features.

READ MORE: Cancer symptoms: The ‘feeling’ that strikes first thing in the morning – it’s a red flag

These included haematuria, a breast lump, difficulty swallowing, iron-deficiency anaemia and postmenopausal or rectal bleeding.

The researchers from the University of Exeter Medical School found that the patient’s likelihood of being referred varied largely depending on the symptoms they presented with.


Haematuria refers to the presence of blood in urine, whether it is visible to the eye or not.

The complication is one of the first known symptoms of bladder cancer and can turn the colour of urine orange, pink, or dark red.


Data shows that between 30 and 90 percent of cancer patients have anaemia, making it another very important red flag.

Several types of anaemia exist, but it is iron-deficient anaemia is most often linked with the disease.

The condition is caused by a deficit of healthy red blood cells in the body, which carry oxygen.

WebMD explains: “Gastrointestinal cancers, like stomach or colon cancer, are known to cause anaemia.

“Bleeding often happens with these conditions. When you bleed a lot, you lose red blood cells faster than your body is able to make them.”

Postmenopausal bleeding

Postmenopausal bleeding is the medical term for vaginal bleeding that happens at least 12 months after a period has stopped, according to the NHS.

Previous studies have shown that more than 90 percent of women diagnosed with endometrial cancer had experienced postmenopausal bleeding.

“Screening all women who experience bleeding after menopause for endometrial cancer could potentially find as many as 90 percent of those cancers,” explains Harvard Health.

Rectal bleeding

Bright red blood in the stool is usually an indication that there is bleeding in the colon or rectum, which is a known sign of cancer.

Bleeding, however, is also commonly caused by haemorrhoids, but the colour of the blood can offer clues as to where the bleeding has occurred.

While bright red blood is more likely to come from the lower digestive tract, dark red blood could be indicative of bleeding in the small intestine.

Like body lumps, many of the aforementioned red flag signs have many known causes, but it is always worth seeing a doctor if you notice unusual changes to your body’s normal functioning.

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