Red flags to screen for tumors in patients with neck pain: a scoping review protocol

BackgroundPeople with malignant (primary or metastatic) or benign tumors may present in clinical practice with neck pain, with or without other symptoms (e.g., radicular pain or headache). When not presenting as an emergency, neck pain is most often assessed by primary care clinicians such as general practitioners, physiotherapists, chiropractors or osteopaths. Therefore, primary care clinicians must be able to screen for tumors when evaluating patients with neck pain. Despite clinical practice guidelines providing recommendations to triage serious conditions presenting as neck pain, there is a paucity of overviews on red flags for tumors in patients presenting with neck pain in primary care settings. The present scoping review aims to comprehensively map the existing literature on red flags for tumors in patients presenting with neck pain in primary care settings. Furthermore, we will aim to identify gaps in the literature to direct future research in this area. MethodsWe will search MEDLINE (via PubMed), Embase, CINHAL, and Scopus. In addition, we will use Web of Science to implement backward and forward citation tracking strategies. We will consider any primary study design written in English or Italian. No time or geographical restrictions will be applied to the search. Studies with a focus on the diagnostic pathway, considering patients of any age and gender with a diagnosis of tumor and a primary complaint of neck pain will be eligible for inclusion. Only studies conducted in primary care settings will be considered. Two authors will independently perform the study selection and data extraction phases. Results from the scoping review will be summarized descriptively through tables and diagrams. As a scoping review, we will highlight any gaps in the existing literature regarding our research questions.