Warning Over Persistent Sore Throat and Cancer Risk
Research suggests that GPs should consider laryngeal cancer in people with a sore throat that won’t go away.
A UK study of patients in general practice has found that a persistent sore throat, particularly when combined with other symptoms such as earache and difficulty swallowing or breathing, could be a previously overlooked warning sign for cancer of the larynx.
The larynx is part of the throat found at the entrance of the windpipe that helps people breathe and speak.
More than 1,700 people are diagnosed with laryngeal cancer each year in England and this number has risen by almost a third over the past 20 years. It is more common in men than women, and strongly linked to tobacco and alcohol use.
Radiotherapy, chemotherapy and surgery are the main treatments, with some patients eventually needing to breathe through a permanent hole in their neck following surgery and use a throat implant or electrical device to speak.
Early diagnosis improves survival and health outcomes but because GPs may not be able to see or feel for signs of laryngeal cancer, they need to decide whether to refer people to a specialist based on their symptoms.
Current National Institute for Health and Care Excellence (NICE) guidance recommends that patients with persistent hoarseness or an unexplained neck lump are investigated for throat or laryngeal cancer.
This study led by the University of Exeter aimed to investigate all the symptoms that might be important for laryngeal cancer. It looked at patient records from more than 600 GP practices and studied 806 patients diagnosed with cancer of the larynx along with 3,559 control patients.
The results revealed that patients who had a persistent sore throat along with shortness of breath, problems swallowing or earache had a more than 5% risk of laryngeal cancer. This was greater than the risk for hoarseness, which was the highest individual risk factor at 2.7%.
This new research, published in the British Journal of General Practice, shows the potential severity of some symptoms previously thought to be low risk. Importantly, it alerts GPs to the combinations of symptoms that they should be aware of when deciding who should be investigated for cancer.
Lead author Dr Elizabeth Shephard said the study highlights the need to improve current guidelines on head and neck cancer: “It’s vital for selecting the right patients for referral. If we get people earlier we can then diagnose the cancer at an earlier stage and they will have access to the right treatment.”
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