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

Background: 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.Methods: Patients diagnosed between the ۱st of January ۲۰۱۳ and the ۳۱st of December ۲۰۱۷ using ICD-۱۰ CD-۳۲ 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.Findings: ۳۲۹ patients in Glasgow, Scotland were included with a mean age of ۶۴.۹۶ ± ۱۰.۹۴ and a follow-up of ۲۴ ± ۱۳.۹۱ months. Of these, ۳۹ reported recreational drug use (RD). RD was associated with younger age (۵۳.۰ vs. ۶۶.۶, p<۰.۰۰۱) at diagnosis with laryngeal cancer. A greater proportion of tumours occurred in the supraglottic subsite (p=۰.۰۴۱). Furthermore, these patients were more likely to undergo tracheostomy (RR=۲.۵۰, ۹۵% CI: ۱.۴۱-۴.۴۴, p=۰.۰۰۸) and laryngectomy (RR=۲.۲۵, ۹۵% CI: ۱.۵۷-۳.۲۱, p<۰.۰۰۱). Recreational drug users were more likely to require enteral feeding support (RR= ۱.۴۴, ۹۵% CI: ۱.۱۳-۱.۸۴, p=۰.۰۲) during oncological treatment. No survival differences were noted at ۱, ۲, or ۳-years (plog-rank=۰.۸۳). 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.Conclusion: 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.

Keywords:

Head and Neck neoplasms , Laryngeal neoplasms , Substance-related disorders , Analgesics , Opioid , Illicit drugs