Shaping better health
REMEDY : BNSSG referral pathways & Joint Formulary

Home > Urgent Suspected Cancer (USC) >

Cancer of Unknown Primary - USC (2WW)

Checked: 23-11-2022 by 3 Vicky Ryan Next Review: 23-11-2023

Service Overview

Cancer of Unknown Primary services are available via 2WW for patients with cancer where the primary disease site is not clear.

Please note that this service is for patients who have radiological evidence of metastatic disease where there is no clear primary origin of cancer. It is not suitable for patients with concerning symptoms but no evidence of cancer where more a more specific 2WW referral may be more appropriate.

An urgent CT of the Chest, Abdomen and Pelvis should be ordered where GP direct access to this test is available.

For more information please see:

NICE guidance - Metastatic Malignant Disease of Unknown Primary Origin (CG104) 

Referral Guidance

Referrals to be made via e-Referral using the Cancer of Unknown Primary Referral Form (word doc). If the patient is from the Weston area, the referral gets sent to Acute oncology at WGH to triage and either accept or reject.

For professional queries about suitability of referral please contact the Cancer of Unknown Primary teams:

For UHB: To discuss referral please contact UHB Cancer of Unknown Primary Team on 0117 342 1295

For NBT: GPs can phone the acute oncology service (AOS) clinical nurse specialist for advice/information on 07860 783116

For Weston: GPs can phone the acute oncology service (AOS) clinical nurse specialist for advice/information on

01934 881080.


If advised to refer into MDT, then please submit a 2WW referral to the relevant secondary care team who will ensure that all the required information is available to enable an effective MDT discussion.

At time of referral please issue the BNSSG Understanding Your Urgent Fast Track Referral patient information leaflet.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.