Urgent Suspected Cancer: Urology

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Under Review — this page was due to be reviewed by Thursday, 04 June 2026. The information shown here may be outdated.

When making an urgent suspected cancer (USC) referral (previously known as two-week waits or 2WW), please ensure your patient understands that they have been referred on a suspected cancer pathway and that they should make themselves available for diagnostic tests and outpatient appointments for the next 28 days.

Guidance for referring patients for suspected prostate cancer

GPs should continue to refer men with suspected prostate cancer on the urgent suspected urological cancer form.
GPs should undertake prostate-specific antigen (PSA) testing in symptomatic patients in line with NICE guidelines (new lower urinary tract symptoms, visible haematuria, unexplained non-visible haematuria with dysuria or raised WCC on blood test).
GPs should continue to undertake PSA testing in asymptomatic patients following GIRFT guidelines.
The age requirement should be lowered to 45 for those with black or mixed black heritage and/or those with a family history of prostate and/or breast cancer.

For further detail on PSA testing see the tumour markers section on the Right Test Right Time page.

How to Refer

EMIS form

Referral methods: e-RS

Actions before making a USC referral

Include any previous PSA results in the referral, as PSA trajectory is useful clinical information.
Ensure that an estimated glomerular filtration rate (eGFR) result from the last three months is included.
Please note: if a PSA or eGFR result is not included, some local trusts, such as University College London Hospitals and North Middlesex University Hospital, will perform the tests, even with a report of an abnormal DRE. This delays access to a multiparametric MRI (MpMRI) until results are available, and therefore bypassing the test in primary care will not hasten secondary care appointments.