The following unexplained, persistent signs and symptoms require investigation, if lasting more than three weeks, or earlier in patients with known risk factors or with more than one sign or symptom:

• new or changed cough
• chest or shoulder pain
• shortness of breath
• hoarseness
• weight loss or loss of appetite
• persistent or recurrent chest infection
• fatigue
• deep vein thrombosis
• abnormal chest signs
• finger clubbing
• cervical or supraclavicular lymphadenopathy
• features suggesting lung cancer metastasis (e.g. brain, bone, liver or skin)
• pleural effusion
• thrombocytosis (Cancer Australia 2020b).

The following signs and symptoms require urgent referral for a chest CT scan and concurrent referral (within two weeks) to a specialist linked to a lung cancer multidisciplinary team:

• persistent or unexplained haemoptysis
• signs of superior vena caval obstruction
• high clinical suspicion of lung cancer
• imaging findings that suggest lung cancer (Cancer Australia 2020b).

The following signs or symptoms require immediate referral to an emergency department:

• massive haemoptysis
• stridor (Cancer Australia 2020b).

The presence of multiple signs and symptoms, particularly in combination with other underlying risk factors, indicates an increased risk of lung cancer.