Rapid referral guidelines for head and neck cancer

See our referral guidelines for head and neck cancer, which includes laryngeal, oral and thyroid cancer..

About these guidelines

We have developed 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

Non urgent

Requires routine referral or tests.


Urgent

Urgent

Required within two weeks.


Very urgent

Very urgent

Required within 48 hours.


Please note, these guidelines aim to share learning and good practice but, out of necessity, they are brief in nature. They are not a substitute for your own clinical judgement or advice provided to you by a specialist.

Macmillan and NICE will not accept any liability for any type of loss caused by someone acting on information contained in the guidelines, unless liability is enforced by law.

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

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

Laryngeal cancer referral guidelines

Very urgent

Urgent referral


Consider urgent referral (appointment within two weeks) for people aged 45 or over with either:

  • persistent, unexplained hoarseness
  • OR an unexplained lump in the neck.

Oral cancer referral guidelines

Non urgent

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.

Thyroid cancer referral guidelines

Very urgent

Urgent referral


Consider urgent referral (appointment within two weeks) for people with an unexplained thyroid lump.

Glossary

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).