2.3 Initial referral

2.3 Initial referral

If the cancer diagnosis is confirmed or the results are inconsistent or indeterminate, the general practitioner or dental practitioner must refer the patient to an appropriate specialist to make the diagnosis. For suspected or confirmed head and neck cancer, referral should be to a head and neck surgeon connected to a head and neck multidisciplinary team. For suspected or confirmed oral cancer, referral could also be made to a maxillofacial surgeon.

Patients should be enabled to make informed decisions about their choice of specialist and health service. General practitioners should make referrals in consultation with the patient after considering the clinical care needed, cost implications (see referral options and informed financial consent), waiting periods, location and facilities, including discussing the patient’s preference for health care through the public or the private system.

Referral for suspected or diagnosed head and neck cancer should include the following essential information to accurately triage and categorise the level of clinical urgency:

  • important psychosocial history and relevant medical history
  • family history, current symptoms, medications and allergies
  • results of current clinical investigations (imaging and pathology reports)
  • results of all prior relevant investigations
  • notification if an interpreter service is required.

Many services will reject incomplete referrals, so it is important that referrals comply with all relevant health service criteria.

If access is via online referral, a lack of a hard copy should not delay referral.

The specialist should provide timely communication to the general practitioner about the consultation and should notify the general practitioner if the patient does not attend appointments.

Aboriginal and Torres Strait Islander patients will need a culturally appropriate referral. To view the optimal care pathway for Aboriginal and Torres Strait Islander people and the corresponding quick reference guide, visit the Cancer Australia website. Download the consumer resources Checking for cancer and Cancer from the Cancer Australia website.

The first specialist appointment should take place within two weeks of the initial referral from the general or dental practitioner.

The patient must be informed about the improved outcomes achieved at centres that treat higher numbers of complex head and neck cancer cases.