Dataset Information

Recognizing sinonasal cancer in primary care: a matched case-control study using electronic records.

ABSTRACT:

Background

Cancers of the nasopharynx, nasal cavity, and accessory sinuses ("sinonasal") are rare in England, with around 750 patients diagnosed annually. There are no specific National Institute for Health and Care Excellence (NICE) referral guidelines for these cancers and no primary care research published.

Objective

To identify and quantify clinical features of sinonasal cancer in UK primary care patients.

Methods

This matched case-control study used UK Clinical Practice Research Datalink (CPRD) data. Patients were aged ≥40 years with a diagnosis of sinonasal cancer between January 1, 2000 and December 31, 2009 and had consulted their GP in the year before diagnosis. Clinical features of sinonasal cancer were analysed using conditional logistic regression. Positive predictive values (PPVs) for single and combined features were calculated.

Results

In total, 155 cases and 697 controls were studied. Nine symptoms and one abnormal investigation were significantly associated with the cancer: nasal mass; odds ratio, 95 (95% confidence interval 7.0, 1315, P = 0.001); head and neck lumps, 68 (12, 387, P < 0.001); epistaxis, 17 (3.9, 70, P < 0.001); rhinorrhoea, 14 (4.6, 44, P < 0.001); visual disturbance, 12 (2.2, 67, P = 0.004); sinusitis, 7.3 (2.2, 25, P = 0.001); sore throat, 6.0 (2.0, 18, P = 0.001); otalgia, 5.4 (1.6, 18, P = 0.007); headache, 3.6 (1.4, 9.5, P = 0.01); raised white cell count, 8.5 (2.8, 27, P < 0.001). Combined PPVs for epistaxis/rhinorrhoea, epistaxis/sinusitis, and rhinorrhoea/sinusitis were 0.62%.

Conclusion

This is the first primary care study identifying epistaxis, sinusitis, and rhinorrhoea as part of the clinical prodrome of sinonasal cancer. Although no PPVs meet the 3% NICE referral threshold, these results may help clinicians identify who warrants safety-netting and possible specialist referral, potentially reducing the number of advanced-stage diagnoses of sinonasal cancer.

SUBMITTER: Khan T

PROVIDER: S-EPMC9155150 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Recognizing sinonasal cancer in primary care: a matched case-control study using electronic records.

Khan Tuba T El-Sockary Yusera Y Hamilton William T WT Shephard Elizabeth A EA

Family practice 20220501 3

<h4>Background</h4>Cancers of the nasopharynx, nasal cavity, and accessory sinuses ("sinonasal") are rare in England, with around 750 patients diagnosed annually. There are no specific National Institute for Health and Care Excellence (NICE) referral guidelines for these cancers and no primary care research published.<h4>Objective</h4>To identify and quantify clinical features of sinonasal cancer in UK primary care patients.<h4>Methods</h4>This matched case-control study used UK Clinical Practic ...[more]

PMID: 34871409

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Dataset Information

Recognizing sinonasal cancer in primary care: a matched case-control study using electronic records.

Background

Objective

Methods

Results

Conclusion

Publications

Recognizing sinonasal cancer in primary care: a matched case-control study using electronic records.

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