Head and Neck Cancers

Emergency referral

  • Stridor

Urgent suspicion of cancer referral

Head and neck cancer:

  • Persistent unexplained head and neck lumps for >3 weeks
  • Unexplained ulceration or unexplained swelling/induration of the oral mucosa persisting for >3 weeks
  • All unexplained red or mixed red and white patches of the oral mucosa persisting for >3 weeks
  • Persistent (not intermittent) hoarseness lasting for >3 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 >3 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.

Full Guideline