2.2 Assessments by the general practitioner
2.2 Assessments by the general practitioner
General practitioner examinations and investigations should include:
- taking of a medical history and a physical examination
- full blood count, B12 and serum iron, liver function tests (LFTs) and renal function, thyroid function, calcium, cholesterol and C-reactive protein (CRP)
- imaging tests, such as ultrasound, chest x-ray (CXR), computed tomography (CT) scans
- referral for endoscopy/colonoscopy or bronchoscopy depending on imaging result.
- Tumour markers – for example, chromogranin A and 24-hour urinary 5HIAA – should be used with caution in the pre-diagnosis stage given the number of common false positives (e.g. chromogranin A may be falsely elevated in the context of proton pump inhibitor usage or renal failure).
See table 1 for specific investigations for the NET location.
Where this is a strong suspicion of NETs, investigations should be conducted within two weeks of the initial general practitioner appointment.
Investigations could be sequential. The appropriate sequence of investigations may vary. When in doubt, formal specialist consultation is advised.
