Nice | Suspected cancer in children

Nice has published an updated guideline on suspected cancer, including cancer in children. It is a huge guideline, so I have done a separate blog for adult cancers.

The BMJ has published an excellent summary including a useful 'infogram' for suspected childhood cancer. One to keep handy somewhere...

The main points are:

  • Abdominal mass / unexplained enlarged abdominal organ - refer in 48 hrs (Wilm's tumour or neuroblastoma).
  • Visible haematuria if unexplained - refer in 48 hrs (Wilm's tumour)
  • Absent red reflex - refer in 2 weeks (retinoblastoma)
  • Soft tissue mass increasing in size - for USS within 48 hrs (sarcoma)
  • Bone swelling or pain if unexplained - for xray within 48 hrs (sarcoma) NB need a FBC too - see below
  • Lymphadenopathy or splenomegaly if unexplained - refer in 48 hrs (lymphoma)
  • Hepatosplenomegaly - refer immediately (leukaemia)
  • Petechiae - refer immediately (leukaemia)
  • Leukaemia possible - do aFBC within 48hrs for any of the following symptoms:
    • pallor
    • persistent fatigue
    • unexplained fever
    • unexplained persistent infection
    • generalised lymphadenopathy
    • unexplained bone pain
    • unexplained bruising or bleeding

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