Head and Neck Cancer

Urgent Referral

Refer urgently patients with

• an unexplained lump in the neck, of recent onset, or a lump that has changed over a period of 3 to 6 weeks
• an unexplained persistent swelling in the parotid or submandibular gland
• an unxplained persistent sore or painful throat
• unilateral unexplained pain in the head and neck area for more than 4 weeks, associated with otalgia but a normal otoscopy
• unexplained ulceration of the oral mucosa or mass persisting for more than 3 weeks
• unexplained red and white patches (including suspected lichen planus) of the oral mucosa that are painful or swollen or bleeding
• hoarseness for more than 6 weeks

Thyroid Cancer

Immediate Referral

• Refer immediately patients with symptoms of tracheal compression including stridor due to thyroid swelling

Urgent Referral

Refer urgently patients with a thyroid swelling associated with any of the following

• a solitary nodule increasing in size
• a history of neck irradiation
• a family history of endocrine tumour
• unexplained hoarseness or voice changes
• cervical lymphadenopathy
• pre-pubertal patient
• patient aged 65 or older