Tips for assessing neck lumps

Gateway C has provided a great resource summarising how to assess neck lumps in primary care.

Link to Gateway C's Article: Tips for assessing neck lumps by gateway C

Key takeaways

• Consider a referral on a suspected cancer pathway for a neck lump that has been present for more than 3 weeks and is over 1cm in size.
• Neck lumps in patients over the age of 35 should raise suspicion for potential malignancy.
• Consider a direct referral for a neck lump on a suspected cancer pathway rather than requesting an ultrasound.  
• Refer all concerning neck lumps on a suspected cancer pathway to a head and neck surgeon, even if hematological malignancy is suspected.  
• Adopt a robust safety netting plan when monitoring neck lumps.  
• Onset: An inflammatory swelling, such a reactive lymph node, is usually acute in onset and resolves within 4-6 weeks. A malignant swelling tends to be the progressive enlargement of lump that does not resolve.
• Children and young adults – Neck masses in children and young adults are more commonly inflammatory or congenital lumps. However, although more common in the older adult population, lymphomas are the most common group of cancers in teenagers and young adults.
• Adults – Human Papilloma Virus (HPV) has caused an increase the number of patients diagnosed with a head and neck cancer; particularly in male patients aged 40-50. Neck lumps in patients over the age of 35 should raise suspicion for malignancy.

‍