The prevalence of oropharyngeal squamous cell carcinoma in patients admitted with symptoms of peritonsillar abscess or cellulitis: A retrospective multicentre study.
Adolescent
Adult
Aged
Aged, 80 and over
Cellulitis
/ epidemiology
Female
Humans
Male
Middle Aged
Oropharyngeal Neoplasms
/ epidemiology
Peritonsillar Abscess
/ epidemiology
Prevalence
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck
/ epidemiology
United Kingdom
/ epidemiology
Young Adult
oropharyngeal
peritonsillar abscess
peritonsillar cellulitis
risk analysis
squamous cell carcinoma
tonsil
Journal
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
ISSN: 1749-4486
Titre abrégé: Clin Otolaryngol
Pays: England
ID NLM: 101247023
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
revised:
08
07
2021
received:
18
03
2021
accepted:
08
08
2021
pubmed:
19
8
2021
medline:
24
2
2022
entrez:
18
8
2021
Statut:
ppublish
Résumé
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. 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. 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%). 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.
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1362-1367Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Schache AG, Powell NG, Cuschieri KS, et al. HPV-related oropharynx cancer in the United Kingdom: an evolution in the understanding of disease etiology. Cancer Res. 2016;76:6598-6606. https://doi.org/10.1158/0008-5472.CAN-16-0633
Ang KK, Harris J, Wheeler R, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010;363:24-35. https://doi.org/10.1056/NEJMoa0912217
McIlwain WR, Sood AJ, Nguyen SA, Day TA. Initial symptoms in patients with HPV-positive and HPV-negative oropharyngeal cancer. JAMA Otolaryngol-Head Neck Surg. 2014;140:441-447. https://doi.org/10.1001/jamaoto.2014.141
Holmes SB, Vora K, Hardee PSG. Squamous cell carcinoma presenting as peritonsillar abscess. Br J Oral Maxillofac Surg. 2001;39:46-48. https://doi.org/10.1054/bjom.2000.0567
Fort MM, Gathings R, Domanski MC. Squamous cell carcinoma of the tonsil masquerading as a peritonsillar abscess. Am J Emerg Med. 2013;31:1002.e3-1002.e4. https://doi.org/10.1016/j.ajem.2013.02.015
The UK Office of National Statistics. Estimates of the population for the UK, England and Wales, Scotland and Northern Ireland. [Internet] London. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/populationestimatesforukenglandandwalesscotlandandnorthernireland Accessed February 26, 2021.
Taib BG, Oakley J, Dailey Y, et al. Socioeconomic deprivation and the burden of head and neck cancer-Regional variations of incidence and mortality in Merseyside and Cheshire, North West. England. Clin Otolaryngol. 2018;43(3):846-853. https://doi.org/10.1111/coa.13067
Kumar S, Little P, Britten N. Why do general practitioners prescribe antibiotics for sore throat? grounded theory interview study. Br Med J. 2003;326:138. https://doi.org/10.1136/bmj.326.7381.138
Scantlebury R, Durbaba S, Sidhu K, Ashworth M, Rowlands G, Schofield P. Socioeconomic deprivation and accident and emergency attendances: cross-sectional analysis of general practices in England. Br J Gen Pract. 2015;65:e649-e654. https://doi.org/10.3399/bjgp15X686893
Pearson-Stuttard J, Davies SC. The health index for England. Lancet. 2021;397:665. https://doi.org/10.1016/S0140-6736(21)00201-4
Bannister M, Ah-See KW. Is oropharyngeal cancer being misdiagnosed as acute tonsillitis? Br J Gen Pract. 2014;64:e742-e744. https://doi.org/10.3399/bjgp14X682537
Rokkjaer MS, Klug TE. Tonsillar malignancy in adult patients with peritonsillar abscess: retrospective study of 275 patients and review of the literature. Eur Arch Oto-Rhino-Laryngol. 2015;272:2439-2444. https://doi.org/10.1007/s00405-014-3186-0