A team of researchers have highlighted that general practitioners (GPs) should consider larynx cancer when patients report a persistent sore throat, particularly when combined with other seemingly low-level symptoms.
The research, published recently in the British Journal of General Practice, aims to facilitate earlier detection of cancer and give greater insight into the combinations of symptoms GPs should be alert to when deciding who should be investigated for cancer, which is key to getting the best survival rates and outcomes for patients.
The study involved 806 patients diagnosed with larynx cancer between 2000 and 2009, together with 3559 age-, sex-, and practice-matched controls, it was conducted using patient records for more than 600 GP practices as part of the UK’s Clinical Practice Research Datalink.
The clinical features of laryngeal cancer that patients had presented to their GP in the year before diagnosis were identified and their association with cancer was assessed using conditional logistic regression.
There were several features that were significantly associated with larynx cancer: hoarseness, sore throat, dysphagia, otalgia, recurrent chest infection, insomnia and raised inflammatory markers.
Symptom combinations currently not included in The National Institute for Health and Care Excellence (NICE) guidance were sore throat plus either dysphagia, dyspnoea, or otalgia, for which positive predictive values were more than 5%.
“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,” one of the authors, Willie Hamilton, of the University of Exeter Medical School (UK) commented.