Login
Search

Search
Search

Suspected Head and Neck Cancers Pathways

NICE guideline [NG12] Suspected cancer: recognition and referral. Last updated: Apr 2025.

Background Information

Historically, if a GP suspected cancer, the patient would be referred under the 2-week wait (2WW) pathway:
  • Patient should be seen by a specialist within 2 weeks
  • But no time limit was set for diagnsois or treatment 

Since October 2021, NHS England replaced the 2WW target with the 28-day Faster Diagnosis Standard (FDS):
  • "Patients who are referred with suspected cancer should be diagnosed (cancer or not) within 28 days of referral."

Laryngeal Cancer

Consiser a suspected cancer pathway referral in:
  • ≥45 y/o, AND
  • Persistent unexpalined hoarseness OR unexpalined neck lump

Oral Cancer

Consiser a suspected cancer pathway referral if:
  • Unexpalined oral ulceration for >3 weeks, OR
  • Persistent unexpalined lump in the neck

Consider urgent referral (within 2 weeks) to dentist if:
  • Lump on the lip or in the oral cavity
  • Red (erythroplakia) or red and white patch (erythroleukoplakia)

If the dentist identifies a lump consistent with oral cancer / erythroplakia / erythroleukoplaia → consider suspected cancer pathway referral.

Thyroid Cancer

Consider a suspected cancer pathway referral if:
  • Unexplained thyroid lump

References

Author: Adams Lau
Reviewer:
Last Edited: 20/04/25