Hoarseness with other low-level symptoms could indicate cancer of larynx – study

GPs should consider cancer of the larynx when patients report a persistent sore throat – particularly when combined with other seemingly low-level symptoms, research suggests.

A study of more than 800 patients diagnosed with cancer of the larynx found more than a 5% risk of cancer from a persistent sore throat combined with shortness of breath, problems swallowing or earache.

This compares with a 2.7% risk for a sore throat alone.

The research aims to assist in the earlier detection of cancer, which is key in getting the best survival rates and health outcomes for patients.

Currently, National Institute for Health and Care Excellence (Nice) guidelines recommend investigation for persistent hoarseness or an unexplained neck lump.

The new research from the University of Exeter gives greater insight into the combinations of symptoms GPs should be alert to when deciding who should be investigated for cancer.

Professor Willie Hamilton, who is one of the study authors, said: “This research matters – when Nice guidance for cancer investigation was published there was no evidence from GP practices to guide this, nor to inform GPs.

“Crucially, hoarseness serious enough to be reported to GPs does warrant investigation.

“Furthermore, our research has shown the potential severity of some symptom combinations previously thought to be low-risk.”

The research was carried out using patient records from more than 600 GP practices as part of the UK’s Clinical Practice Research Datalink.

Each year, more than 1,700 people were diagnosed with cancer of the larynx and, of those, 80% were male.

The numbers have risen by almost a third over the past 20 years, with tobacco and alcohol use strongly linked to the disease.

Lead author Dr Elizabeth Shephard said: “The UK still lags well behind the rest of Europe on cancer survival rate, although our research is part of a body of work that is leading to significant improvements.

“There’s still some way to go and the results of this study really highlight the need to improve the current recommendations for all of the head and neck cancers, which are either incomplete or absent.”

The study, Recognising Laryngeal Cancer In Primary Care: A Large Case-control Study Using Electronic Records, is published in the British Journal of General Practice.

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