Persistent sore throat plus either otalgia, dyspnea or dysphagia was a stronger indicator of laryngeal cancer than hoarseness alone, according to findings recently published in the British Journal of General Practice.
“It is unclear which symptoms from the disparate range reported in previous research are associated with laryngeal cancer in primary care,” Elizabeth A. Shepherd, PhD, CPsychol, and research fellow at the University of Exeter Medical School in Exeter, England, and colleagues wrote.
Researchers compared symptoms of 806 patients with laryngeal cancer vs. 3,559 control patients from the United Kingdom’s Clinical Practice Research Datalink. All patients were aged 40 years and older.
Shepherd and colleagues found patients with hoarseness had the highest individual risk for laryngeal cancer at 2.7%. This risk increased to 5% or more when the patient had sore throat with recurrent dyspnea, otalgia or dysphagia. The risk dropped to 3% or more when the hoarseness was accompanied by these same symptoms as well as mouth symptoms and insomnia.
Other symptoms significantly associated with laryngeal cancer were first visit for sore throat (OR = 6.2; 95% CI, 3.7-10); second visit for sore throat (OR = 7.7; 95% CI, 2.6-23); recurrent chest infection (OR = 4.5; 95% CI, 2.4-8.5); and raised inflammatory markers (OR = 2.5; 95% CI, 1.5-4.1).
“This study has resulted in an evidence base for the identification of possible laryngeal cancer in primary care patients who are symptomatic,” Shepherd and colleagues wrote.
“However, selection of patients for investigation is not simply a matter of totting up symptoms and [positive predictive values]. Clinical experience — although almost impossible to measure — adds to skillful decision making.” – by Janel Miller
Disclosures: Shepherd reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.