Guidance on the referral of lesions suspicious of cancer

Question 1

What should you do if you find a lesion that you think is suspicious for oral cancer?

Answer 1

Referral guidance:

• scottish referral guidelines for suspected cancer
• suspected cancer: recognition and referral: NICE guidelines NG12

Question 2

What are the aims of the scottish referral guidelines for suspected cancer?

Answer 2

• to facilitate appropriate referral between primary and secondary care for patients whom a GP suspects may have cancer
• intended to help GPs, wider primary care team, other clinicials, patients and carers identify patients who are most likely to have cancer and who therefore require urgent assessment by a specialist

Question 3

According to the scottish referral guidelines, when should you refer a patient for urgent suspicion of cancer?

Answer 3

• persistent unexplained head and neck lump > 3 weeks
• unexplained ulceration or unexplained swelling/induration of the oral mucosa persisting > 3 weeks
• all unexplained red or mixed red and white patches of the oral mucosa persisting > 3 weeks
• persistent (not intermittent) hoarseness lasting for > 3 weeks
• persistent pain in the throat or pain on swallowing lasting for > 3 weeks
• patient should be seen within 2 weeks

Question 4

According to NICE guidelines, what do they state for suspected oral cancer?

Answer 4

Consider a suspected cancer pathway referral (appointment within 2 weeks) for oral cancer in people with either:

• unexplained ulceration in the oral cavity lasting more than 3 weeks

OR

• a persistent and unexplained lump in the neck

OR

• a lump on the lip or in the oral cavity

OR

• a red or red and white patch in the oral cavity consistent with erythroplakia or erythroleukoplakia