ArticleClinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery2026
Compliance and Effectiveness of the Scottish Referral Guidelines for Suspected Head and Neck Cancer: A Comparative Audit of 7088 Referrals.
Article in Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionIn Scotland, patients with suspected head and neck cancer are referred based on the Scottish Referral Guidelines for Suspected Cancer (SRGSC). These were most recently updated in 2014 and 2019. A study using 2015-2016 data reported a compliance rate with the 2014 guidance of 55.1% and an all-cancer detection rate of 11.6% (8.6% primary head and neck cancer). This audit assessed referral compliance with the 2019 SRGSC and investigated what effect this update had on rates of head and neck cancer detection.
methodsAll 'urgent suspicion of cancer' referrals to the ENT department in the National Health Service Greater Glasgow and Clyde (NHS GGC) for 2021-2022 were audited and compared to corresponding data from 2015 to 2016.
resultsThe number of referrals increased by 110% between 2015-2016 and 2021-2022. SRGSC compliance in referral letters was 72.5%, but only 48.9% when those patients were assessed in the ENT clinic. The all-cancer detection rate was 8.6% (6.2% primary head and neck cancer). The most common reasons for referral were neck lump (28%), persistent hoarseness (15%), and persistent throat pain (11%). The most common primary head and neck cancer sites were oropharynx (18%), larynx (17%), and thyroid (11%). There were significant differences between the 2015-2016 and 2021-2022 cohorts in age at referral, sex, and risk factors.
conclusionCompared to corresponding data from 2015 to 2016, there is increased workload in 'urgent suspicion of cancer' clinic for fewer cancer diagnoses. When compliant, the SRGSHNC criteria are a valuable predictive tool for cancer diagnosis.
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