Scottish referral guidelines for suspected cancer: quick reference guide

Scottish Referral Guidelines for Suspected Cancer is a quick reference guide for cancer referrals.

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.

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