Trends in Laryngeal Cancer Staging: Are We Detecting Cases Earlier? Insights from a London Hospital

Introduction: This study seeks to pinpoint delays in the presentation, diagnosis, and management of laryngeal cancers, aiming to enhance early-stage diagnoses in accordance with the NHS Long Term Plan, which targets 75% early-stage cancer detection and improved survival rates.

Methods: This retrospective descriptive study evaluated 103 patients who received treatment for laryngeal cancer at a London hospital between 2016 and 2022. The data collected included demographic information, clinical and pathological staging, diagnostic imaging findings, smoking history, comorbidities, treatment details, and social factors potentially contributing to delays in diagnosis or treatment, with the aim of identifying changes in numbers of early and late stage cancers.

Results: Analysis indicated that between 2016 and 2020, a higher percentage of cancers were identified at advanced stages compared to those found early. However, starting in 2021, there was a shift in this trend, with more cancers being detected at earlier stages than those diagnosed later. Additionally, there was a significant decrease in the total number of patients diagnosed with laryngeal cancer.

Conclusions: This study demonstrates an increase in the early stage diagnosis of laryngeal cancer in keeping with the NHS long-term plan. This improvement has resulted in fewer patients needing laryngectomy as a treatment option. The rise in early diagnoses can be attributed to several factors, including improved pathways, an increase in the number of Head and Neck consultants within the trust and investigations initiated by the neck lump or triage nurse before the consultant surgeon's review. In addition the implementation of transnasal oesophagoscopy/clinic biopsies has been critical. We plan to complete the audit loop after formally implementing these strategies.