Introduction
Head and neck cancer is an umbrella term. It typically includes:
- Oral cavity cancers
- Cancers of the pharynx (including the oropharynx, hypopharynx and nasopharynx)
- Cancers of the larynx
Epidemiology
- Incidence: 19.00 cases per 100,000 person-years
- Peak incidence: 60-70 years
- Sex ratio: more common in males 2.2:1
| Condition | Relative incidence |
|---|---|
| Nasal polyps | 5.26 |
| Head and neck cancer | 1 |
| <1 | 1-5 | 6+ | 16+ | 30+ | 40+ | 50+ | 60+ | 70+ | 80+ |
Clinical features
Symptoms
- Weight loss (50%)
- Hoarseness (30%)
- Neck lump (30%)
- Mouth pain (15%)
- Oral cavity lump (15%)
- Mouth ulcers (15%)
- Sore throat (15%)
- Unilateral hearing loss (2%): This may be seen in nasopharyngeal cancer.
Referral criteria
NICE cancer referral guidelines for head and neck cancer suggest the following:
Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for laryngeal cancer in people aged 45 and over with:
Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for oral cancer in people with either:
Consider an urgent referral (for an appointment within 2 weeks) for assessment for possible oral cancer by a dentist in people who have either:
Consider a suspected cancer pathway referral by the dentist (for an appointment within 2 weeks) for oral cancer in people when assessed by a dentist as having either:
Laryngeal cancer
Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for laryngeal cancer in people aged 45 and over with:
- persistent unexplained hoarseness or
- an unexplained lump in the neck.
Oral cancer
Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for oral cancer in people with either:
- unexplained ulceration in the oral cavity lasting for more than 3 weeks or
- a persistent and unexplained lump in the neck.
Consider an urgent referral (for an appointment within 2 weeks) for assessment for possible oral cancer by a dentist in people who have either:
- 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.
Consider a suspected cancer pathway referral by the dentist (for an appointment within 2 weeks) for oral cancer in people when assessed by a dentist as having either:
- a lump on the lip or in the oral cavity consistent with oral cancer or
- a red or red and white patch in the oral cavity consistent with erythroplakia or erythroleukoplakia.