Introduction
Head and Neck Cancers (HNC) constitute a major public health concern
worldwide. The worldwide incidence is more than 550000 cases per
yearwith approximately 350000 deaths per annum (1). In
2017, about 63030 new cases of oral cavity, pharyngeal and laryngeal
cancers were reported to occur in the USA (about 3.7% of all new
cases), with an estimated 13360 deaths from HNC during the same time
period (2).
The incidence of HNC is increasing sharply in developing
countries.(1) HNC ranks third in Africa with a
combined Age Standardized Incidence Ratio (ASIR) of
7.8(3) Looking at the Sub-Saharan region, HNC ranks
fourth with an estimated incidence of 27593 per 100000 and a cumulative
risk of 0.66 (1,3). An increasing trend in the
incidence of HNC in South Africa has been reported over the years from
1992 to 2001, and it was observed that mixed ancestry South Africans had
the highest incidence amongst all ethnicities(4).
There are numerous, well-established risk factors. These include
tobacco, alcohol, high-risk human papilloma virus (HR-HPV) exposure,
Epstein Barr Virus (EBV) infection, trauma, poor oral health, dietary
deficiencies and betel leaf chewing.
The incidence of HNC increases with age, and most patients are between
50 and 70 years of age. (5). The most common
histologic type is squamous cell carcinoma, which accounts for
approximately 90% of all HNC. Over 50% of HNC occur in men(5). In particular, males are more likely to have
HPV-positive cancers (5).
Predictors of overall survival include older age, higher tumour stage,
high alcohol consumption and HPV status (6). Survival
decreases with increasing stage of the disease. The 5-year overall
survival is 83% for localised disease, 63% for regional disease and
38% for distant disease (2).
HPV-positive cancers tend to have a better outcome in comparison to
HPV-negative HNC. Limited data onthe epidemiological trends of HNC in
Southern Africa exist. The aim of the current study was to evaluate and
describe patient demographics, risk factors, tumours characteristics,
prognostic factors, disease stage, treatment intent/modality, at a major
referral hospital (Blinded for review) in Southern Africa. This
information may help to reduce the burden of HNC in this region, through
establishing sustainable research and education networks within Africa,
in collaboration with the more developed world.