[Early detection of laryngeal carcinoma: limited improvement possible]

In the majority of cases, laryngeal cancer is located in the glottis, which gives rise to symptoms of hoarseness at an early stage. These symptoms lead to a high rate (85%) of early detection of glottic cancer. Laryngeal carcinoma at other sites in the larynx is associated with symptoms of hoarseness, difficulties in swallowing and dyspnoea at a later stage. Improvements in awareness, speed of referral, identification of patients at risk and available techniques may result in earlier detection. However, if current Dutch national practice guidelines, of which a revised version has recently been published, are followed it would seem that the possibility of further improvements in early detection of laryngeal carcinoma is limited at this moment.