Suspected Cancer: 2 Week Wait
If clinical concerns but doesn't appear to fit criteria, consider using A&G through ERS.
Urgent referrals under the 2-week rule for suspected cancer. The presence of the following symptoms or signs in association with a thyroid swelling may indicate more aggressive or advanced disease and should be referred urgently under the 2-week rule:
- Unexplained hoarseness or voice change.
- Thyroid nodule/goitre in a child.
- Cervical lymphadenopathy associated with a thyroid lump (usually deep cervical or supraclavicular region).
- A rapidly enlarging painless thyroid mass over a period of weeks (a rare presentation of thyroid cancer and usually associated with anaplastic thyroid cancer or thyroid lymphoma).
Cancer Less Likely
Non-urgent referrals. The following patients should be referred in the normal way:
- Patients with nodules who have abnormal thyroid function tests (TFTs) should be referred to an endocrinologist (thyroid cancer is very rare in this group).
- Patients with a history of sudden onset of pain in a thyroid lump (likely to have bled into a benign thyroid cyst).
- Patients with a thyroid lump that is newly presenting or has been increasing in size over months.
Significant Weight Loss Only?