What criteria should be used to determine the need for urgent referral to a specialist for a patient with rectal bleeding?

Criteria for urgent referral to a specialist for a patient presenting with rectal bleeding include:

• Age 50 and over with unexplained rectal bleeding: offer quantitative faecal immunochemical testing (FIT) to assess colorectal cancer risk and consider urgent referral if indicated ¹.
• Adults under 50 with rectal bleeding accompanied by unexplained abdominal pain or weight loss: offer quantitative FIT and consider urgent referral based on results ¹.
• Presence of a rectal mass on examination: consider urgent referral via a suspected cancer pathway ¹.
• Unexplained anal mass or anal ulceration: consider urgent referral via a suspected cancer pathway ¹.

These criteria aim to identify patients at higher risk of colorectal or anal cancer who require prompt specialist assessment ¹.