Incidence of Head and Neck Cancer with Isolated Complaint of Globus Pharyngeus Is Low

by Linda Kossoff •

CLINICAL QUESTION

What is the incidence of head and neck cancer (HNC) in patients diagnosed with globus pharyngeus (GP)?

BOTTOM LINE

The overall incidence of developing a head and neck cancer with a presenting symptom of globus is low.

BACKGROUND: GP is the vague sensation of having something stuck in the throat. With no single known etiology, GP is likely multifactorial. It often results in extensive workup, partially due to concern for underlying malignancy. Analyses evaluating the rate of malignancy among these patients have been small and limited.

STUDY DESIGN: Retrospective study.

SETTING: Department of Otolaryngology–Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio.

SYNOPSIS: Researchers captured longitudinal data from two academic institutions to identify patients with a new diagnosis of GP in 2015, to allow for a follow-up period of at least four years. Of an initial 1,020 patients identified, a total of 377 patients (64.65% female, mean age 56.48 years) were included in the final cohort. Within this group, four patients (1%) ultimately received a new diagnosis of HNC, and 18 patients developed other types of non-HNCs after globus over the period. The most common provider specialty on the first visit was otolaryngology (39.52%), followed by family medicine (21.22%), internal medicine (19.36%), and gastroenterology (7.16%). Over the follow-up period, there were 817 visits, 317 of which were otolaryngology. Most patients saw otolaryngologists at some point regardless of who performed their initial evaluation, suggesting a strong disposition to consult otolaryngologists. Authors acknowledged several challenges in identifying and evaluating this patient subset, including the variability of coding and documentation practices and the potential for missed patients, as well as overlap.

CITATION: Maronian N, Cabrera C, Dewey J, et al. The development of head and neck cancer in patients with the isolated complaint of globus pharyngeus. Laryngoscope. 2024;134:1147–1154.