Scottish referral guidelines for suspected cancer: quick reference guide

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