How should I approach the investigation of a patient presenting with unexplained weight loss and abdominal pain to rule out gastric cancer?

For a patient presenting with unexplained weight loss and abdominal pain, consider referring using a suspected cancer pathway referral for oesophageal or stomach cancer if they are aged 55 and over with upper abdominal pain and weight loss ¹.

If the patient is aged 55 and over with weight loss and low haemoglobin levels, raised platelet count, nausea, or vomiting, consider a non-urgent, direct access upper gastrointestinal endoscopy ¹.

If the patient is aged 40 and over with unexplained abdominal pain and weight loss, offer quantitative faecal immunochemical testing to investigate colorectal cancer ¹.

In cases where there is suspicion of pancreatic cancer with weight loss and abdominal pain in patients aged 60 and over, consider an urgent, direct access CT scan (to be done within 2 weeks) or an urgent ultrasound scan if CT is unavailable ¹.