HNSCCUP Audit 2021:


The first of two articles from the HNSCCUP audit has now been published in Clinical Otolaryngology, read it here!


Head & Neck squamous cell carcinoma of unknown primary (HNSCCUP) presents a diagnostic and therapeutic challenge to the multidisciplinary team (MDT). Strategies to identify the primary tumour site remain controversial.

Various standards and guidelines may help guide this practice, four of which are summarised here.

Endorsed by the ENT-UK Head & Neck Society (letter of support), and supported by a grant from the ENT UK Foundation Research Grants Programme, INTEGRATE are conducting a national audit to investigate the diagnostic pathway, management and outcomes of patients presenting with metastatic nodal neck SCC with no identified primary site on initial outpatient examination who subsequently undergo PET CT.

The overall aim is to understand current diagnostic practice, focussing on radiological and cytological/histological investigations. Treatment strategies and outcomes will also be described.

The data collection window is now closed.

Centrally collated anonymised data will be presented at the Head & Neck Squamous Cell Carcinoma of Unknown Primary Multidisciplinary Consensus Day on 15th November 2021; A national event that aims to ​​achieve consensus on aspects of HNSCCUP diagnosis and management, and to inform the forthcoming 6th edition of the UK head and neck cancer multidisciplinary guidelines.

How to take part…

  • Register your intended participation with INTEGRATE here
  • Join the WhatsApp chat for help and advice
  • Register with your local clinical governance/audit dept
  • Identify your patients
    • Contact your MDT coordinator, or informatics dept, to find patients with N+ SCC who underwent a PET CT within 3 months of diagnosis from 1/1/15 to 1/1/20
    • Then look at the first clinic letter to see if it was managed as an unknown primary at that time.
  • Collect your data
    • Follow instructions on the Excel Data Tool
    • Make a backup copy of the file, then create an anonymised version by deleting all dates/identifiables (leaving only durations)
  • Submit your data


Trainee Site Leads, Consultant Leads and a Local Collaborator/data collector will be acknowledged in any subsequent outputs. Specifically:

  • The ENT UK HNSCCUP Multidisciplinary Consensus Day – 15th November 2021.
  • Any subsequent presentations / publications.


Whatsapp support

QR code to join WhatsApp group


Data from these 55 sites has been analysed as of 4th Nov 2021: