HEAD AND NECK CANCER IN A DEVELOPING COUNTRY- A HOSPITAL BASED RETROSPECTIVE STUDY ACROSS 10 YEARS FROM PAKISTAN
Abstract
Purpose: Head and neck cancers (HNC) are among the most common cancers in developing countries, especially in the Southeast Asia. Oral cavity is the most commonly affected site. The risk factors are tobacco, betel nut and alcohol. The dimensions of the disease are quite different in developing countries than the western world. Poor socioeconomic status, poverty, lack of healthcare facilities and illiteracy are the factors that pose a major challenge to the management of the disease. The aim of this study is to analyse the database that has been collected over a period of 10 years showing the trends of the disease and the management outcome of these individuals.
Methods: Men and women diagnosed with HNC from 2004 to 2014 from Cancer Registry Database of Shaukat Khanum Memorial Cancer Hospital and Research Centre have been retrospectively analysed.
Results: In the 10 year period a total of 5027 patients presented to the head and neck clinic at our institution with a mean age + standard deviation of patients of 58.33 + 20.54. Oral cavity (42.6%) and larynx (13%) were the two most
common sites followed by the less frequent ones. Squamous cell carcinoma ranked as the most common histological type presented to our institute (69.2%), followed by basal cell carcinoma (6.6%), mucoepidermoid carcinoma (4%), adenoid cystic carcinoma (3.6%) and 1.9% adenocarcinoma.
Conclusions: Being a third world country, the burden of the disease on the healthcare system is enormous. With limited resources and funding, there is a need to train people in the speciality and develop the National Cancer Control
Program (NCCP) for better monitoring and disease control.
Key words: Developing country, head and neck cancer, health infrastructure
References
Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2007. CA Cancer J Clin 2007;57:43-66.
Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127:2893-917.
Boyle P, Levin B. World Cancer Report. International Agency for Research on Cancer; 2008.
Kreimer AR, Clifford GM, Boyle P, et al. Human papillomavirus types in head and neck squamous cell carcinomas worldwide: A systematic review. Cancer Epidemiol Biomarkers Prev 2005;14:467-75.
Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009;45:309-16.
Ahluwalia KP. Assessing the oral cancer risk of South-Asian immigrants in New York City. Cancer 2005;104:2959-61.
Vigneswaran N, Tilashalski K, Rodu B, et al. Tobacco use and cancer. A reappraisal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80:178-82.
Patel SC, Carpenter WR, Tyree S, et al. Increasing incidence of oral tongue squamous cell carcinoma in young white women, age 18 to 44 years. J Clin Oncol 2011;29:1488-94.
Harris SL, Kimple RJ, Hayes DN, et al. Never-smokers, never-drinkers: Unique clinical subgroup of young patients with head and neck squamous cell cancers. Head Neck 2010;32:499-503.
Bhurgri Y, Bhurgri A, Nishter S, et al. Pakistan country profile of cancer and cancer control 1995-2004. J Pak Med Assoc 2006;56:124-30.
Chaudhry S, Khan AA, Mirza KM, et al. Estimating the burden of head and neck cancers in the public health sector of Pakistan. Asian Pac J Cancer Prev 2008;9:529-32.
Joshi P, Dutta S, Chaturvedi P, et al. Head and neck cancers in developing countries. Rambam Maimonides Med J 2014; 5:e0009.
Khawaja MR, Mazahir S, Majeed A, et al. Chewing of betel, areca and tobacco: Perceptions and knowledge regarding their role in head and neck cancers in an urban squatter settlement in Pakistan. Asian Pac J Cancer Prev 2006;7:95‑100.
Mehrotra R, Singh M, Gupta RK, et al. Trends of prevalence and pathological spectrum of head and neck cancers in North India. Indian J Cancer 2005;42:89-93.
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