Recognising laryngeal cancer in primary care

Current guidance from the National Institute for Health and Care Excellence (NICE) suggests urgent referral for suspected laryngeal cancer in patients presenting with persistent unexplained hoarseness or unexplained neck lump. Using electronic records, this case-control study aimed to identify and quantify the primary care features of laryngeal cancer. In total, 806 patients were diagnosed with laryngeal cancer between 2000-2009. Hoarseness was the symptom with the highest individual risk of laryngeal cancer, with an individual positive predictive value (PPV) of 2.7%. Patients reporting combined symptom combinations not identified in current NICE guidance – such as sore throat with dysphagia, with recurrent dyspnoea, or with otalgia – had risk estimates of >5%. These results expand on current cancer guidelines and may improve GPs’ future selection of patients for referral for suspected laryngeal cancer.

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