Sore throat that won't go away 'could be sign of cancer', doctors warned

'Hoarseness serious enough to be reported to GPs does warrant investigation,' says Professor Willie Hamilton of study which could help speed up diagnosis

Alex Matthews-King
Health Correspondent
Tuesday 29 January 2019 10:29
Sore throat can guide GPs to refer more, particularly in combination with other symptoms
Sore throat can guide GPs to refer more, particularly in combination with other symptoms

A persistent sore throat, particularly when combined with other common symptoms like earache and difficulty swallowing, could be a warning sign for cancer of the larynx, according to new research.

GPs have been told that hoarseness which is severe enough to prompt a patient to seek an appointment should make them think seriously about referring to a specialist.

In a study of more than 800 patients who had been diagnosed with larynx cancer, and around 3,500 healthy people, persistent sore throat combined with low level symptoms accounted for a 5 per cent risk.

A persistent sore throat on its own accounted for a 2.7 per cent risk, and considered alongside a patient’s smoking status and age could help guide further testing.

There are around 2,000 diagnosed cancers of the larynx – also known as the voice box – in the UK each year, and the research is intended to catch them early with the best chance of survival.

Currently, National Institute for Health and Care Excellence (Nice) guidelines recommend investigation for persistent hoarseness or an unexplained neck lump – but not how GPs should implement this.

“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,” said Professor Willie Hamilton, one of the authors of the study in the British Journal of General Practice from the University of Exeter.

“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.”

Around 80 per cent of larynx cancers are diagnosed in men, and overall numbers have risen by almost a third over the past 20 years, with tobacco and alcohol use strongly linked to the disease.

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Lead author Dr Elizabeth Shephard said: “The UK still lags well behind the rest of Europe on cancer survival rates, although our research is part of a body of work that is leading to significant improvements.

“There’s still some way to go and the results of this study really highlight the need to improve the current recommendations for all of the head and neck cancers, which are either incomplete or absent.”

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