What are the current guidelines for referring a patient with suspected nasopharyngeal carcinoma to an ENT specialist?

Refer a patient with suspected nasopharyngeal carcinoma to an ear, nose, and throat (ENT) specialist using a suspected cancer pathway referral if they present with symptoms suggestive of upper aerodigestive tract cancer, such as unexplained neck lumps or persistent symptoms related to the nasopharynx. Consider urgent referral especially if the patient is of Chinese or south-east Asian family origin presenting with hearing loss and a middle ear effusion not associated with an upper respiratory tract infection, as this group has a higher risk of nasopharyngeal carcinoma. Additionally, if there is a persistent unexplained lump in the neck or other symptoms consistent with head and neck cancers, a suspected cancer pathway referral to ENT is warranted. Early investigation including imaging and biopsy should be coordinated by the specialist team after referral.

In summary, use a suspected cancer pathway referral to ENT for patients with clinical features suggestive of nasopharyngeal carcinoma, particularly unexplained neck lumps, persistent symptoms in the nasopharyngeal area, or relevant risk factors such as ethnicity and associated middle ear effusion.

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