Scottish referral guidelines for suspected cancer: quick reference guide

Head and Neck Cancers

Increased risk if heavy smoker and/or drinker and male >45 yrs. Other forms of tobacco use should also arouse suspicion.

• Stridor - emergency referral.
• Hoarseness lasting >3 weeks.
• Discomfort in throat >3 weeks (especially in smoker or drinker).
• Dysphagia.
• Head and neck lumps for >3 weeks.
• Ulceration of oral mucosa persisting >3 weeks.
• Oral swellings persisting >3 weeks.
• All red or red and white patches of oral mucosa >3 weeks.
• Unexplained tooth mobility not associated with periodontal disease.

Thyroid Cancer

• Solitary nodule increasing in size.
• Thyroid swelling in pre-pubertal patient.
• Thyroid swelling with the following risk factors:
• Neck irradiation.
• Family history of endocrine tumour.
• Unexplained hoarseness.
• Cervical lymphadenopathy.
• Age >65.

Patients with hyper or hypothyroidism and an associated goitre should be referred routinely to an endocrinologist.