Head and neck cancer referral guidelines

We have developed our Rapid Referral Guidelines to support GPs with practical referral recommendations for children, young people and adults with symptoms of suspected cancer. The guidelines are endorsed by NICE and summarise the NG12 guidelines for suspected cancer. They can help you decide if a referral is:

Non urgent

Requires routine referral or tests.

Urgent

Required within two weeks.

Very urgent

Required within 48 hours.

We have recommendations on patient support, safety netting and the diagnostic process.

You can also download a copy of the guidelines (PDF).

Urgent referral

Consider urgent referral (appointment within two weeks) for people with:

• an unexplained ulceration in the oral cavity that lasts for more than three weeks
• OR a persistent and unexplained lump in the neck.

Consider urgently referring (appointment within two weeks) people to a dentist for assessment if they have:

• an unexplained lump on the lip or in the oral cavity
• OR a red or red-and-white patch in the oral cavity that’s consistent with erythroplakia or erythroleukoplakia.

A dentist should consider urgent referral (appointment within two weeks) for people with either of the following, after a dental surgeon has assessed and concluded the symptom is consistent with oral cancer:

• a lump on the lip or the oral cavity
• OR a red or red-and-white patch in the oral cavity that’s consistent with erythroplakia or erythroleukoplakia.

In these guidelines, we use the below terms in the way they are described.

This is consistent with NICE's NG12 guidance for suspected cancer.

• Children – from birth to 15 years.
• Young people – people aged 16–24.
• Direct access – when a test is performed and primary care retain clinical responsibility throughout, including acting on the result.
• Immediate – an acute admission or referral occurring within a few hours, or even more quickly, if necessary.
• Suspected cancer pathway referral – the patient is seen within the national target for cancer referrals (two weeks at the time of publication of the 2015 NICE guidance).