If a lesion suspicious of cancer is detected

Evidence levels for the recommendations are given in italic in square brackets.Investigations for diagnosis and stagingConfirming a diagnosis of colorectal cancerThe recommendations in this section refer to people whose condition is being managed in secondary care. For recommendations for urgent referral from primary care for patients with suspected colorectal cancer, see the NICE clinical guideline 27.3Advise the patient that more than one investigation may be necessary to confirm or exclude a diagnosis of colorectal cancer.Offer colonoscopy to patients without major comorbidity. If a lesion suspicious of cancer is detected, perform a biopsy unless contraindicated (for example, in patients with bleeding disorders).For patients with major comorbidity, offer flexible sigmoidoscopy followed by a barium enema.

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