Under the two-week rule, which symptom is NOT a reason to refer a patient for further investigation?

Under the two-week rule, which is a guideline used in the United Kingdom to expedite referrals for suspected serious conditions, particularly cancer, symptoms that indicate a potential malignancy warrant urgent investigation.

In this context, new onset of rectal bleeding, tenesmus, and altered bowel habits lasting more than six weeks are all red flag symptoms that could suggest colorectal cancer or other serious gastrointestinal conditions. These symptoms typically indicate a need for prompt evaluation to rule out life-threatening diagnoses.

In contrast, an increased appetite, while potentially indicative of a change in a patient's health status, is generally not a symptom associated with serious conditions requiring urgent referral under the two-week rule. An increase in appetite is less definitive in terms of signaling a serious underlying pathology compared to the other symptoms mentioned, which are more commonly associated with cancers that necessitate quick intervention. Thus, this symptom does not fit the criteria for urgent referral established by the guideline.