What are the key clinical features that should raise suspicion for head and neck cancer in a patient presenting with a neck lump?

Key clinical features that should raise suspicion of head and neck cancer in a patient presenting with a neck lump include:

• An unexplained neck lump in a person aged 45 years or older.
• A persistent and unexplained neck lump at any age, defined as a lump present beyond the expected duration of a self-limiting condition and without a diagnosis after initial assessment.
• Neck lump associated with persistent unexplained hoarseness, especially in people aged 45 and over, which may suggest laryngeal cancer.
• Unexplained ulceration in the oral cavity lasting more than 3 weeks or a lump on the lip or in the oral cavity consistent with oral cancer.
• Neck lump that is increasing in size, warranting urgent imaging such as a neck ultrasound.
• Associated symptoms such as alcohol-induced lymph node pain, weight loss, night sweats, or other systemic symptoms that may suggest lymphoma.

These features warrant urgent referral via a 2-week suspected cancer pathway to a head and neck specialist for further assessment, imaging, and possible biopsy to exclude malignancy.