Symptom Combos Suggesting Laryngeal Cancer Identified
10 features of laryngeal cancer with which patients presented in year before diagnosis identified
THURSDAY, Jan. 31, 2019 (Pharmacist's Briefing) -- New symptom combinations that may indicate early symptoms of laryngeal cancer have been identified, according to a study published online Jan. 28 in the British Journal of General Practice.
Elizabeth A. Shephard, Ph.D., from the University of Exeter Medical School in the United Kingdom, and colleagues conducted a matched case-control study of patients aged ≥40 years to examine the clinical features of laryngeal cancer with which patients presented to their general practitioner in the year before diagnosis.
The researchers identified 806 patients who were diagnosed with laryngeal cancer between 2000 and 2009; the patients were matched with 3,559 controls based on age, sex, and practice. Significant associations were identified for 10 features with laryngeal cancer: hoarseness (odds ratio, 904); sore throat, first attendance (odds ratio, 6.2); sore throat, reattendance (odds ratio, 7.7); dysphagia (odds ratio, 6.5); otalgia (odds ratio, 5); dyspnea, reattendance (odds ratio, 4.7); mouth symptoms (odds ratio, 4.7); recurrent chest infection (odds ratio, 4.5); insomnia (odds ratio, 2.7); and raised inflammatory markers (odds ratio, 2.5). The highest individual positive predictive value (PPV) was 2.7 percent for hoarseness. The symptom combinations of sore throat plus either dysphagia, dyspnea, or otalgia are not currently included in the National Institute for Health and Care Excellence (NICE) guidelines; PPVs for these combinations were >5 percent.
"These results expand current NICE guidance by identifying new symptom combinations that are associated with laryngeal cancer; they may help general practitioners to select more appropriate patients for referral," the authors write.