What are the referral criteria for patients with haematochezia to secondary care?

Referral criteria for patients presenting with haematochezia (rectal bleeding) to secondary care:

• Patients aged 50 and over with unexplained rectal bleeding should be offered quantitative faecal immunochemical testing (FIT) to assess the risk of colorectal cancer and guide referral decisions.
• Adults under 50 presenting with rectal bleeding accompanied by unexplained abdominal pain or weight loss should also be offered quantitative FIT to evaluate the need for urgent referral.
• If FIT results or clinical assessment indicate a significant risk of colorectal cancer, consider referral via a suspected cancer pathway to secondary care for further investigation, such as colonoscopy.

These criteria aim to identify patients at higher risk of colorectal cancer who require urgent assessment in secondary care, while managing lower-risk cases appropriately in primary care.

Note: The guidelines do not specify direct referral solely based on haematochezia without other risk factors or positive FIT results.

References: NICE NG12