Synopsis
Recognise suspected lung cancer promptly and sequence imaging, tissue, staging and fitness assessment so each test answers a treatment decision without avoidable duplication or delay.
- Persistent or unexplained haemoptysis, cough, breathlessness, chest or shoulder pain, weight loss, hoarseness, clubbing, lymphadenopathy or recurrent focal infection can signal lung cancer.
- Follow NICE suspected-cancer referral criteria: urgent chest imaging or pathway referral is driven by age, smoking history, symptom combinations and abnormal imaging, not by a single universal presentation.
- A normal chest radiograph does not exclude central, small or hidden lung cancer when clinical concern persists; review the image and escalate according to the whole presentation.
Key red flags
Life-threatening haemoptysis requires airway, oxygenation, haemodynamic resuscitation and urgent interventional or surgical coordination before the routine diagnostic sequence.
Investigation priorities
Provide rapid initial imaging for symptom-triggered suspected lung cancer.
Management branches
NICE referral criteria, concerning persistent symptoms, abnormal chest imaging or a compatible paraneoplastic syndrome.
- Take a focused symptom, smoking and occupational history, examine for nodes, effusion, collapse, clubbing and metastatic or emergency features, and review prior imaging.
- Apply current NICE NG12 criteria for urgent radiography or suspected-cancer referral, documenting why persistent concern remains if the initial chest radiograph is normal.