Latest NICE guidance on oral cancer referrals

In 2015 NICE updated their cancer referral guidance and you can download a copy from here. The guidance with respect to oral cancer has been revised and in simpler.

NICE Guideline NG12 – Referring Suspected Cancers
Updated June 2015 – Visit NICE here
Download here

There is an excellent resource from Cancer Research UK – the Oral Cancer toolkit and an accompanying learning resource and CPD from the BDA. In short the referral guidelines state that:

You should 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

The CRUK have also produced a short, 3 minute video on examining a patient for head and neck health.  You can view it here

Learning & resources

You can access the learning by clicking on the link below.  There is also an excellent referral decision aid that you can quickly access to understand more about the new NICE guidelines.

Access the CRUK/BDA oral cancer toolkit with learning programme and lesion recognition here.

In addition to the NICE guidelines for England and Wales, it is worth considering the “red flags” that the Scottish Guidelines recommend:

• Red flag 1: Persistent unexplained head and neck lumps for >3 weeks.
• Red flag 2: An ulceration or unexplained swelling of the oral mucosa persisting for >3 weeks.
• Red flag 3: All red or mixed red and white patches of the oral mucosa persisting for >3 weeks.
• Red flag 4: Unexplained tooth mobility not associated with periodontal disease.
• Red flag 5: Persistent, particularly unilateral, discomfort in the throat for >4 weeks.
• Red flag 6: Ear pain without evidence of local ear abnormalities.

You might also find this article, kindly provided by Dental Update, helpful in assessing patient.