Gastroenterology — UKMLA MCQ
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Correct answer: B — Urgent suspected upper gastrointestinal cancer referral
Dysphagia is itself an alarm feature for oesophageal cancer referral, and weight loss increases concern. Refer urgently for upper gastrointestinal assessment and endoscopy rather than treating empirically for months. Acid suppression may continue for symptoms but must not delay investigation of obstruction or malignancy.
Reference: NICE NG12: suspected oesophageal cancer recognition and referral. https://www.nice.org.uk/guidance/ng12/chapter/1-Recommendations-organised-by-site-of-cancer#upper-gastrointestinal-tract-cancers; NHS: dysphagia assessment. https://www.nhs.uk/conditions/swallowing-problems-dysphagia/