Scottish referral guidelines for suspected cancer: quick reference guide

User-friendly visual aid to the urgent referral criteria as well as routine referral criteria and primary care management and good practice points.


Head and Neck Cancers

Emergency referral

  • Stridor

Urgent suspicion of cancer referral

Head and neck Cancer

  • Persistent unexplained head and neck lumps for >three weeks
  • Unexplained ulceration or unexplained swelling/induration of the oral mucosa persisting for >three weeks
  • All unexplained red or mixed red and white patches of the oral mucosa persisting for >three weeks
  • Persistent (not intermittent) hoarseness lasting for >three weeks. If other symptoms are present to suggest suspicion of lung cancer, refer via lung cancer guideline
  • Persistent pain in the throat or pain on swallowing lasting for >three weeks

Thyroid cancer

  • Solitary nodule increasing in size
  • Thyroid swelling age 16 and under
  • Thyroid swelling with one or more of the following risk factors:
  • neck irradiation
  • family history of endocrine tumour
  • unexplained hoarseness
  • cervical lymphadenopathy

Good practice points

  • With the changing pattern of disease (in particular HPV associated cancers), age, non-smoking or non-drinking status should not be a barrier to referral
  • Dentists are key to identifying early cancer in the head and neck. There should be systems in place for urgent suspicion of cancer referral pathways for dentists

Contact

Email: Cancer Access Team

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