This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on June 3, 2022.
Throat cancers may develop in different parts of the throat. Some throat cancers start in the voice box (the larynx), also called laryngeal cancers. Others start in the lower part of the throat (the hypopharynx), also called hypopharyngeal cancers. The most common type of cancer in the larynx and hypopharynx is squamous cell carcinoma, because it develops within the squamous cells lining these areas.
Rarer types of throat cancer include:
Throat cancers are typically discovered due to the symptoms they cause, so it’s important to watch for early signs and symptoms. These may differ depending on where the cancer starts within the throat.
If a doctor suspects throat cancer based on symptoms or possible pre-cancerous signs, they may refer the patient to an ENT (ear, nose and throat) doctor, also known as an otolaryngologist.
A dentist and/or dental hygienist may also check the face, neck, lips and mouth for signs of possible throat cancer during regular checkups. If necessary, they’ll refer the patient to an otolaryngologist for further examination.
Doctors may also look for oral cancers using a panoramic dental X-ray, which captures the entire mouth in 2D.
If they can’t determine the cause of the sore throat, they may recommend a throat swab culture (using a swab to gather a sample of any bacteria and other organisms present in the throat). More commonly, throat cultures help diagnose infections like strep throat. But they may be useful in spotting abnormalities that require further testing, including those below.
A sample of throat tissues or cells is required for a biopsy, which must be conducted before treatment begins. The types of biopsies typically used for diagnosing throat and other head and neck cancers are:
Endoscopic biopsy: An instrument called an endoscope is inserted into one of the nostrils or the mouth. The endoscope has a light and a video camera on one end, which allows the surgeon to see the area being biopsied. The endoscope is also hollow, which allows the surgeon to pass instruments through it. These instruments are used to remove a sample from an abnormal-looking area.
Incisional biopsy: In this procedure, a small piece of tissue is cut from an abnormal-looking area. Because the larynx is deep inside the neck, removing samples involves a complex procedure. Biopsies in this region are usually performed in an operating room, with general anesthesia administered to prevent pain.
Fine needle aspiration (FNA): A very thin needle attached to a syringe is used to extract (aspirate) cells from a tumor or lump.
Various imaging tests may be performed to help formulate a throat cancer diagnosis, including:
Ultrasound: Ultrasounds catch echoes from sound waves to create an image of an area inside the body. Doctors may order a neck ultrasound to look for signs of oral cancer. Signs may include swollen or abnormally shaped lymph nodes. Doctors may also use ultrasound to guide the needle during a FNA.
CT scan: A CT scan may provide information about the size, shape and position of any tumors, and may also help identify enlarged lymph nodes that may contain cancer cells.
Barium swallow: A barium swallow test may show irregularities in the different parts of the throat, and may often detect small, early tumors.
Magnetic resonance imaging (MRI): Commonly, an MRI scan may be used to examine throat cancer. MRIs provide a very detailed view, and may help determine whether or not the cancer has spread, either to other areas in the neck or other regions of the body.
Positron emission tomography (PET): For patients diagnosed with throat cancer, a PET/CT scan may be used to see if cancer has spread to the lymph nodes, to determine the origin of cancer when it is found in the lymph nodes first, or to check the body for the spread of cancer cells.
X-ray: An X-ray of the chest may be taken to check if the cancer has spread to the lungs. Cancer will not be present in the lungs unless it has advanced.
Other diagnostic procedures for throat cancer evaluations often involve some type of scope used to inspect the deeper areas of the throat. For example:
Panendoscopy: Also called an upper endoscopy, this test may help doctors detect throat cancer through an exam of the upper digestive system. The upper digestive system includes the larynx, esophagus, stomach and first part of the small intestine. In this exam, an individual is given general anesthesia in an operating room so that the entire region of the body can be closely inspected for cancer. Endoscopes are used to look at the back of the throat, larynx, esophagus and possibly the windpipe (trachea) and bronchi. Other parts of your nose, mouth and throat, including the trachea (windpipe) and esophagus, are also examined during this procedure. The doctor performing the procedure will look for any visible signs of a tumor. Doctors may use a special instrument through the scope to biopsy pieces of tissue that look potentially cancerous.
Laryngoscopy: For this procedure, your doctor may spray your nose or the back of your throat with a numbing medicine to avoid pain. Because throat cancers are close to other areas of the head and neck, your doctor may also examine your mouth, nose and neck.
Pharyngoscopy: Like with a laryngoscopy, the doctor may use a spray to numb the back of your throat. Because pharyngeal cancer raises risk for other head and neck cancers, your doctor will also examine the mouth, tongue, larynx and neck for signs of abnormalities.
The results from imaging tests and a biopsy help confirm a cancer diagnosis, including where it may be located and whether it has spread.
Many of the tests performed to help diagnose throat cancer also help determine the stage. Throat cancer stages range from 1 to 4. The stage of the cancer indicates how far it has spread from its original location, which will impact how the cancer will be treated and how serious it is.
Next topic: How is throat cancer treated?