2.3 Initial referral
If the general practitioner suspects a cancer diagnosis or an aggressive lymphoma histological diagnosis has not been performed, they must refer the patient to an appropriate specialist who has access to multidisciplinary support to make the diagnosis.
If the general practitioner confirms a cancer diagnosis with initial tests, they must then refer the patient to a haematologist or medical oncologist with professional expertise in lymphoma management.
Patients should be enabled to make informed decisions about their choice of specialist and health service. General practitioners should make referrals in consultation with the patient after considering the clinical care needed, cost implications (see referral options and informed financial consent), waiting periods, location and facilities, including discussing the patient’s preference for health care through the public or the private system.
Referral for suspected or diagnosed Hodgkin lymphoma and DLBCL should include the following essential information to accurately triage and categorise the level of clinical urgency:
- important psychosocial history and relevant medical history
- family history, current symptoms, medications and allergies
- results of current clinical investigations (imaging and pathology reports)
- results of all prior relevant investigations
- notification if an interpreter service is required.
Many services will reject incomplete referrals, so it is important that referrals comply with all relevant health service criteria.
If access is via online referral, a lack of a hard copy should not delay referral.
The specialist should provide timely communication to the general practitioner about the consultation and should notify the general practitioner if the patient does not attend appointments.
Aboriginal and Torres Strait Islander patients will need a culturally appropriate referral. To view the optimal care pathway for Aboriginal and Torres Strait Islander people and the corresponding quick reference guide, visit the Cancer Australia website. Download the consumer resources – Checking for cancer and Cancer from the Cancer Australia website.
- If the presence of lymphoma is highly likely based on the initial consultation with the general practitioner, referral for urgent tissue diagnosis is needed, followed by urgent referral to a specialist centre for further assessment within 72 hours.
- For patients who underwent further investigations (if indicators of concern are absent), referral to a specialist should occur within four weeks.
- Patients under observation should be reviewed by their general practitioner within six weeks of initial presentation.
