Persistent Sore Throat: A Sign of Laryngeal Cancer

A study published in the British Journal of General Practice identified new predictors of laryngeal cancer: Persistent sore throat plus either otalgia, dyspnea, or dysphagia was a stronger indicator of laryngeal cancer than hoarseness alone.

This matched, case-control study identified patients aged ≥40 years from the United Kingdom’s Clinical Practice Research Datalink. Clinical features of laryngeal cancer with which patients had presented to their general practitioner in the year before diagnosis were identified and their association with cancer was assessed using conditional logistic regression.

Researchers identified 806 patients diagnosed with laryngeal cancer between 2000 and 2009; they were compared with 3,559 age-, sex-, and practice-matched controls.

Features associated with laryngeal cancer

Ten features were significantly associated with laryngeal cancer (P<0.01 for all):

1. Hoarseness (odds ratio [OR] = 904; 95% CI, 277-2945)
2. Sore throat, first attendance (OR=6.2; 95% CI, 3.7-10)
3. Sore throat, re-attendance (OR=7.7; 95% CI, 2.6-23)
4. Dysphagia (OR=6.5; 95% CI, 2.7-16)
5. Otalgia (OR=5.0; 95% CI, 1.9 to 13)
6. Dyspnea, re-attendance (OR=4.7; 95% CI, 1.9-12)
7. Mouth symptoms (OR=4.7; 95% CI, 1.8-12)
8. Recurrent chest infection (OR=4.5; 95% CI, 2.4-8.5)
9. Insomnia (OR=2.7; 95% CI, 1.3-5.6)
10. Increased inflammatory markers (OR=2.5; 95% CI, 1.5-4.1)

Symptom combinations give physicians new ways to spot cancer

Hoarseness was 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.

“These results expand current National Institute for Health and Care Excellence guidance by identifying new symptom combinations that are associated with laryngeal cancer,” the authors concluded. “They may help general practitioners to select more appropriate patients for referral.”

Persistent sore throat may be a warning sign for laryngeal cancer, study suggests https://t.co/o7EDZi5tDJ

— Brock D. Norwood (@mrbrocknorwood) January 29, 2019