Does recreational drug use influence survival and morbidity associated with laryngeal cancer

The use of opioids is considered a risk factor for laryngeal cancer. A retrospective study was performed to explore the relationship between recreational drug exposure and laryngeal cancer.

Patients diagnosed between the 1st of January 2013 and the 31st of December 2017 using ICD-10 CD-32 coding were identified from the Head and Neck Multidisciplinary Team database. We divided the study population into two cohorts (RD and non-RD) and compared the demographics, morbidity, and outcomes of these two populations. In addition, we performed case-matched analysis to control for potential confounding factors including gender, alcohol use and cigarette smoking.

329 patients in Glasgow, Scotland were included with a mean age of 64.96 ± 10.94 and a follow-up of 24 ± 13.91 months. Of these, 39 reported recreational drug use (RD). RD was associated with younger age (53.0 vs. 66.6, p<0.001) at diagnosis with laryngeal cancer. A greater proportion of tumours occurred in the supraglottic subsite (p=0.041). Furthermore, these patients were more likely to undergo tracheostomy (RR=2.50, 95% CI: 1.41-4.44, p=0.008) and laryngectomy (RR=2.25, 95% CI: 1.57-3.21, p<0.001). Recreational drug users were more likely to require enteral feeding support (RR= 1.44, 95% CI: 1.13-1.84, p=0.02) during oncological treatment. No survival differences were noted at 1, 2, or 3-years (_plog-rank=0.83). Case matched analysis correcting for smoking, alcohol and gender confirmed that recreational drug users were younger at diagnosis with a predilection for the supraglottic subsite.

Recreational drug use is associated with an increased burden of disease and morbidity in laryngeal cancer. We suggest that clinicians view recreational drug exposure as a red flag in those with suspected laryngeal cancer regardless of patient age.