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Τρίτη 12 Ιανουαρίου 2021

Patterns of urgent hoarseness referrals to ENT – When should we be suspicious of cancer?

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Abstract

Persistent hoarseness, as a symptom of laryngeal cancer, is one of the most frequent referrals made in the "urgent suspicion of cancer" (USOC) category in Scotland. This is equivalent to the "2 week wait" category in England. The Scottish Referral Guidelines (SRG) make no exclusions on age of patients with hoarseness, unlike the NICE guidelines (1) which stipulate that referrals are only received for patients 45 years or older. Hoarseness as a presentation of laryngeal cancer is important. Most head and neck cancers present in advanced stages, yet hoarseness as a presenting symptom can be a marker of early stage disease (2). The vast majority of patients referred with hoarseness can be safely reassured and discharge following examination and while much is currently published on the risk of having laryngeal cancer (3,4), examining other factors in relation to laryngeal health and focusing on the lower risk benign group is an understudied area.

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