For further detail about risk assessment of hoarseness, please see:
Neck Lump and Throat Cancer Risk Assessment opens a new window.
Acute hoarseness is almost always due to an acute viral illness (laryngitis) and this can persist for a while. Cancers are associated with constant (rather than intermittent) hoarseness, occur in older people (mean age of diagnosis is 64 in large Scottish study) and those who smoke. A history of alcohol excess and deprivation are also significant risk factors.
Hoarseness due to infection can take some time to settle. Where there is a clear explanation for symptoms (persistent or post infection), and particularly when the person is otherwise low risk (<40, non-smoking, < 3 weeks) then it is appropriate to make a clinical judgement about duration of symptoms before referring.
Please consider other red flags particularly persistent throat pain (SoreThroat.aspx opens a new window), neck lump (NeckLump.aspx opens a new window), symptoms suggestive of lung cancer, or a suspicious oral lesion.
Persistent (NOT INTERMITTENT) hoarseness lasting for > three weeks should be referred urgently, suspicious of cancer (Scottish Referral Guidelines for Suspected Cancer opens a new window).
But please note:
- This relates to PERSISTENT rather than INTERMITTENT hoarseness
- The easiest and most reliable way to risk-assess for a persistent hoarseness is to use the validated Head and Neck Cancer Risk Calculator:
http://www.orlhealth.com/risk-calculator-2.html opens a new window
C.M. & I.N. 02-04-25
