Cancer in childhood is thankfully rare, although the incidence is increasing, with currently approximately 2000 children being diagnosed with cancer every year in the UK. Leukaemia, lymphoma and central nervous system (CNS) tumours account for two thirds of new diagnoses, with leukaemia being the most common (Cancer Research UK).
Deaths from cancer in childhood account for less than 1% of all cancer deaths in the UK, with brain and other CNS tumours accounting for most deaths. Overall mortality rates are reducing with early recognition and prompt initial management of cancer in childhood.
Please ensure that before considering referral for potential childhood cancer a full history from the main carers and physical examination of the child has been completed in primary care.
The presence of the following symptoms or physical signs are concerning for childhood cancer and must be fully explored:
The HeadSmart charity is an extremely useful resource providing information regarding symptoms and physical signs of brain and CNS tumours in children, designed to promote the rapid early detection of brain tumours in childhood – HeadSmart – HeadSmart
Please contact the Paediatric Consultant telephone advice line for all suspected childhood cancers where the most appropriate route of referral into hospital can be discussed – this is accessed via switchboard (0208 546 7711) and is held Mon-Fri 9-5 by a Consultant. Out of hours, please ask switch for the PAU Phone or Paediatric Registrar. This may include referral in for same day review, or a 2 week wait referral for a clinic appointment with a Paediatric Consultant with Oncology interest.
If considering a 2 week wait referral please refer to the following Pan-London Suspected Cancer Referral Guide for Children for further information – Pan-London-Suspected-Cancer-Referral-Guide-Children.pdf
Please ensure that the form is fully completed, including history, examination details, and any investigations already completed. Please ensure also that the 2 week wait pathway process has been discussed with the carers and child if appropriate. Please note that suspected bone and skin cancers, and retinoblastomas, have separate Pan-London 2 week wait referral forms, due to initial assessment being undertaken at specialist centres. Please ensure that the appropriate form is accurately completed to ensure no delays in referral.
NICE Suspected Cancer Recognition and Referral Symptom Reference Guide nice_infographic_poster_march2016.pdf (cancerresearchuk.org)
HeadSmart
Pan-London 2ww referral guideline link
