Is oropharyngeal cancer being misdiagnosed as acute tonsillitis?

Bannister, Miles; Ah‐See, Kim

doi:10.3399/bjgp14x682537

Cited by 7 publications

(8 citation statements)

References 6 publications

(6 reference statements)

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“…The proportion of head and neck cancer patients presenting through emergency pathways in this study is favourable compared to other reports 18 19 However, over the study period, there was a trend towards a greater proportion of patients presenting through emergency pathways, from 2.2 per cent in 2010 to 6.2 per cent in 2014.…”

Section: Discussioncontrasting

confidence: 62%

“…– 16 However, emergency admissions to hospital for cancer patients may be an indication of diagnostic delay in primary care 17 . In our region, we noted that a number of patients with oropharyngeal cancer were misdiagnosed as suffering acute tonsillitis and reputedly treated with antibiotics, despite not being in the accepted age group for this acute infection 18 . Other factors associated with emergency presentation include rural location and older age, which broadly correlates with the patient profile in our series 18 .…”

Section: Discussionmentioning

confidence: 66%

“…In our region, we noted that a number of patients with oropharyngeal cancer were misdiagnosed as suffering acute tonsillitis and reputedly treated with antibiotics, despite not being in the accepted age group for this acute infection 18 . Other factors associated with emergency presentation include rural location and older age, which broadly correlates with the patient profile in our series 18 . These factors may account for the advanced stages of cancers seen in all presentations.…”

Section: Discussionmentioning

confidence: 68%

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Emergency presentations of head and neck cancer: a modern perspective

2016

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 68%

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Emergency presentations of head and neck cancer: a modern perspective

2016

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“…Cases of malignancy can be missed and referral to specialist services (head and neck clinic) is delayed if signs and symptoms are mimicked by infective conditions such as tonsillitis and peri-tonsillar abscesses. It is important to remember that tonsillitis is much less common in older adults, and so a high degree of suspicion should be had, especially if patients present with recurrent or unilateral symptoms and have additional risk factors (Bannister and Ah-See, 2014).…”

Section: Historymentioning

confidence: 99%

Oropharyngeal cancer

et al. 2020

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The incidence of oropharyngeal cancer in the UK has almost trebled in the last few decades and continues to climb. It is expected that its associated symptoms will become increasingly common presenting complaints in primary care, where early recognition is hugely advantageous for patient outcomes. Thorough history and examination, plus a sound knowledge of associated risk factors, is vital in identifying potential cases, and an understanding of the correct referral pathways ensures patients are appropriately referred to head and neck cancer services. A broad overview of benign differential diagnoses, subsequent investigation and management of oropharyngeal cancers is helpful in order to properly inform and support patients in their next steps.

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“…11 The average time period from first presentation to GP and referral to ENT was 34 days (range 0-84 days). These findings suggest that patients with OPSCC commonly present in primary care with a sore throat and are often thought to have tonsillitis at first.…”

mentioning

confidence: 99%

The prevalence of oropharyngeal squamous cell carcinoma in patients admitted with symptoms of peritonsillar abscess or cellulitis: A retrospective multicentre study

Lau

Milinis

Roode

et al. 2021

Clinical Otolaryngology

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Objectives: Anecdotal evidence suggests that oropharyngeal squamous cell carcinoma (OPSCC) should be suspected in patients presenting with symptoms of peritonsillar abscess (PTA) or cellulitis (PTC). The aim of this study was to estimate the prevalence of OPSCC in patients presenting with symptoms of PTA/PTC. Method, Setting and Participants:We retrospectively identified all adults with a coded diagnosis of PTA or PTC who presented between 2012 and 2016 inclusive, across six ENT units in Merseyside. Records were compared to that of the centralised regional head and neck cancer database. The clinical records of a subset of patients were reviewed for the purposes of data validation.Results: A total of 1975 patients with PTA/PTC were identified. Three patients were subsequently diagnosed with OPSCC. None of the three actually had an objective underlying diagnosis of PTA/PTC on the same side. The prevalence of OPSCC in patients admitted with symptoms of PTA/PTC was 0.15% or approximately 1:650 admissions.The records of 510 patients who presented over a one-year period (2016) were reviewed in even greater detail. There were 298 patients with PTA (59.4%) and 151 with PTC (29.1%) and 61 had an alternative diagnosis (11.9%). High-risk features (age ≥40, tonsillar asymmetry or tonsillar lesion) were present in 106 patients (24%). Urgent follow-up was expedited for 77 patients (73%). Conclusion:This study estimates the risk of OPSCC in patients with peritonsillar symptoms. The prevalence is low, even in a region with a relatively heavy disease burden. Clinicians should, however, retain a high level of suspicion in patients with persistent symptoms.

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Is oropharyngeal cancer being misdiagnosed as acute tonsillitis?

Cited by 7 publications

References 6 publications

Emergency presentations of head and neck cancer: a modern perspective

Emergency presentations of head and neck cancer: a modern perspective

Oropharyngeal cancer

The prevalence of oropharyngeal squamous cell carcinoma in patients admitted with symptoms of peritonsillar abscess or cellulitis: A retrospective multicentre study

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