Head and Neck Cancers

This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents an overview of head and neck cancers, including epidemiology, etiology, screening, pathology, staging, and treatment. The chapter focuses on cancers of the upper aerodigestive tract which are most often squamous cell carcinomas arising from the squamous epithelium that lines the tract.https://escholarship.umassmed.edu/cancer_concepts/1021/thumbnail.jp

Prevalence of human papillomavirus in head and neck cancers in European populations: a meta-analysis.

BACKGROUND: Infection with human papillomavirus (HPV) is necessary for the development of cervical carcinoma. By contrast, the role of HPV in the pathogenesis of other malignancies, such as head and neck cancers, is less well characterised. This study aimed to address key information gaps by conducting a systematic review and meta-analysis of the prevalence of HPV infection in head and neck cancers, focusing on data for European populations. METHODS: MEDLINE, Embase and grey literature sources were systematically searched for primary studies that were published in English between July 2002 and July 2012, and which reported on the prevalence of HPV infection in head and neck cancers in European populations. Studies on non-European populations, those not published in English, and those assessing patients co-infected with human immunodeficiency virus were excluded. Eligible studies were combined in a meta-analysis. In addition, the potential statistical association between the head and neck cancers and certain HPV types was investigated. RESULTS: Thirty-nine publications met the inclusion criteria. The prevalence of HPV of any type in 3,649 patients with head and neck cancers was 40.0% (95% confidence interval, 34.6% to 45.5%), and was highest in tonsillar cancer (66.4%) and lowest in pharyngeal (15.3%) and tongue (25.7%) cancers. There were no statistically significant associations between the HPV types analysed and the geographical setting, type of sample analysed or type of primer used to analyse samples in head and neck cancers. CONCLUSIONS: The prevalence of HPV infection in European patients with head and neck cancers is high but varies between the different anatomical sites of these malignancies. There appears to be no association between HPV type and geographical setting, type of samples analysed or type of primer used to analyse samples in such cancers

Metal concentrations in hair of patients with various head and neck cancers as a diagnostic aid

Head and neck cancers are one of the most frequent cancers worldwide. This paper attempts to evaluate disturbances of homeostasis of the necessary elements (calcium, magnesium, zinc, copper, iron, manganese) and changes in the levels of toxic metals (lead, cadmium, cobalt, chromium VI) in hair of patients with head and neck cancers, as well as people without a diagnosed neoplastic disease. In order to quantify the necessary elements and toxic metals, a method using ICP-MS and ICP-OES techniques had been developed and validated. The studies have shown that patients with head and neck cancer used to drink alcohol and smoked much more frequently than healthy individuals, both in the past and presently. Statistically significant differences in concentrations of average metal content in the group of patients with head and neck cancers compared to the control group were confirmed. Significant differences in metal content between the group of patients with head and neck cancers and healthy individuals were found which enabled distinguishing between the study groups. To this end, a more advanced statistical tool, i.e. chemometrics, was used. The conducted research analyses and the use of advanced statistical techniques confirm the benefits of using alternative material to distinguish the patients with head and neck cancers from the healthy individuals

Quality of care indicators for head and neck cancers: The experience of the European Project RARECAREnet

Background: Monitoring and improving quality of cancer care has become pivotal today. This is especially relevant for head and neck cancers since the disease is complex, it needs multi therapy, patients tend to be older, they tend to have comorbidities and limited social support. However, information on quality of care for head and neck cancers is scarce. In the context of the project "Information Network on Rare Cancers" we aimed to identify indicators of quality of care specific for the head and neck cancers management and to measure the quality of care for head and neck cancers in different EU Member States. Methods: We defined indicators of quality of care for head and neck cancers based on a multidisciplinary and expert-based consensus process at a European level. To test the proposed indicators, we performed an observational population-based retrospective study in four countries (Ireland, Italy, Netherlands, and Slovenia) in the years 2009-2011. Results: The main quality indicators identified are: availability of formalized multidisciplinary team, participation in clinical and translational research; timeliness of care, high quality of surgery and radiotherapy, and of pathological reporting. For head and neck cancers, the quality of care did not reach the optimal standards in most of the countries analyzed. A high proportion of patients was diagnosed at an advanced disease stage, showed delays in starting treatment (especially for radiotherapy), and there was only a very limited use of multi therapy. Conclusions: According to the achieved consensus, indicators of quality of care for head and neck cancers have to cover the patient journey (i.e., diagnosis and treatment). Our results, showed suboptimal quality of care across countries and call for solutions for ensuring good quality of care for head and neck cancer patients in all EU countries. One possible option might be to refer head and neck cancer patients to specialized centers or to networks including specialized centers

Quality of care indicators for head and neck cancers : the experience of the European project RARECAREnet

Background: Monitoring and improving quality of cancer care has become pivotal today. This is especially relevant for head and neck cancers since the disease is complex, it needs multi therapy, patients tend to be older, they tend to have comorbidities and limited social support. However, information on quality of care for head and neck cancers is scarce. In the context of the project "Information Network on Rare Cancers" we aimed to identify indicators of quality of care specific for the head and neck cancers management and to measure the quality of care for head and neck cancers in different EU Member States. Methods: We defined indicators of quality of care for head and neck cancers based on a multidisciplinary and expert-based consensus process at a European level. To test the proposed indicators, we performed an observational population-based retrospective study in four countries (Ireland, Italy, Netherlands, and Slovenia) in the years 2009-2011. Results: The main quality indicators identified are: availability of formalized multidisciplinary team, participation in clinical and translational research; timeliness of care, high quality of surgery and radiotherapy, and of pathological reporting. For head and neck cancers, the quality of care did not reach the optimal standards in most of the countries analyzed. A high proportion of patients was diagnosed at an advanced disease stage, showed delays in starting treatment (especially for radiotherapy), and there was only a very limited use of multi therapy. Conclusions: According to the achieved consensus, indicators of quality of care for head and neck cancers have to cover the patient journey (i.e., diagnosis and treatment). Our results, showed suboptimal quality of care across countries and call for solutions for ensuring good quality of care for head and neck cancer patients in all EU countries. One possible option might be to refer head and neck cancer patients to specialized centers or to networks including specialized centers

Head and neck cancers in Australia

This report on head and neck cancers in Australia presents the latest available information on incidence, mortality, survival and hospitalisations. Overview Head and neck cancer is a term used to describe a range of cancers that occur in the throat (pharynx and larynx), nose, sinuses and mouth. This report presents the most recent data available on head and neck cancer incidence, mortality, survival and hospitalisations and also describes risk factors that can contribute to a person developing head and neck cancer. The report also includes a \u27spotlight\u27 section which discusses the human papillomavirus (HPV) and how it contributes to head and neck cancers. Incidence The number of head and neck cancers diagnosed in Australia is increasing. From 1982 to 2009, the number of head and neck cancers diagnosed rose from 2,475 to 3,896. While the number of cases diagnosed is rising, the age-standardised incidence rate for head and neck cancers fell from 19.3 per 100,000 persons in 1982 to 16.8 per 100,000 in 2009. Increases in the overall number of cases diagnosed are occurring, despite decreases in age-standardised incidence rates, because of Australia\u27s increasing and ageing population. The number of cases diagnosed in 2009 was higher for males than females. Males accounted for 73.8% (2,875) of head and neck cancers compared to 26.2% (1,021) for females. Mortality Similar to the number of cases diagnosed, the number of deaths from head and neck cancers rose from 752 in 1982 to 944 in 2011. The age-standardised mortality rate fell from 6.1 per 100,000 persons in 1982 to 3.8 per 100,000 in 2011. Increases in the overall number of deaths due to head and neck cancers are occurring, despite a drop in the age-standardised mortality rates, because of the growth and ageing of Australia\u27s population. Males accounted for a higher number of deaths in 2011 than females, with 73.2% (691) of deaths from head and neck cancers among males compared to 26.8% (253) for females. Survival Overall survival from head and neck cancers is improving. There was a rise in 5-year relative survival from 61.8% in 1982-1987 to 68.2% in 2006-2010. One-year relative survival for males and females in 2006-2010 were broadly comparable. However, 5-year relative survival for females was higher at 70.4% compared to males at 67.4%. Hospitalisations Hositalisations for head and neck cancers are also rising. In 2011-12, there were 8,478 hospitalisations where head and neck cancer was the principal diagnosis. This was an increase of 13.8% from 2002-03 when there were 7,448 hospitalisations. The number of hospitalisations for surgery where head and neck cancer was the principal diagnosis also increased over time, from 3,305 in 2002-03 to 3,725 in 2011-12. This was an overall increase of 12.7%

Head and Neck Cancers four year trend at the Nairobi Cancer Registry

Background: Data on head and neck cancers is scarce in the developing countries including Africa. These cancers are more common in the Western countries. In the USA for instance, over 50,000 new cases occur annually. Head and neck cancers subtypes include oral cancers, oral pharyngeal cancers, larynx and nasopharyngeal cancers. Some of the associated causes of head and neck cancers include oncogenic viruses, irradiation, dietary factors and genetic predisposition. These cancers present a major challenge in their management due to their occurrence near vital structures of the head and neck region. Diagnosis or screening is difficult in the early stages due to the hidden nature of the lesions often resulting in late clinical presentation. Treatment modalities include surgery, radiotherapy and chemotherapy alone or in combination. Study Design: This was a retrospective study. Materials and Methods: We reviewed data from the population based Nairobi Cancer Registry (NCR) for the occurrence of Head and Neck Cancers (HNC’s) in relation to the frequencies of all cancers registered within the period between 2000-2003. We also determined the demographical, clinical and the histological features of these cancers. Results: For the period 2000-2003, head and neck cancers comprised over 12.8% (697) of all the 5462 cancers reported from all cancer sites with a male to female ratio of 2:1. Among the head and neck sub-sites, oral cancers were the highest at 40.6%, followed by nasopharynx and laryngeal cancers with 20.8% and 13.8 % respectively. The commonest histology was squamous cell carcinoma. Conclusion: According to the cancer cases registered with the Nairobi Cancer Registry within the analysed period, Head and neck cancers comprised of a significant problem of all the cancers. They are characterised by high rates of oral and nasopharyngeal cancers

Burden of head and neck cancers in Kamrup urban district cancer registry of Assam, India: a retrospective study

Background: Head and Neck cancers are basically squamous cell carcinomas. It is the fifth most common cancer and the sixth most common cause of cancer mortality in the world. Incidence of cancer as a whole for all sites is fourth highest in Kamrup Urban District (KUD) in males (AAR 185.2) and second highest (AAR 156.3) in females out of all Population Based Cancer Registries (PBCR) in India. Incidence of head and neck cancers in KUD is quite high both nationally and internationally. This retrospective study was carried out to assess the incidence pattern of head and neck cancers in Kamrup Urban District of Assam, India for the period of 2009-2011.  Methods: Cancer is not notifiable in India, so method of collecting information on cancer was active in PBCR Guwahati. A total of 4416 cases were registered during the three years (1st January 2009- 31st December 2011) of which 2508 were male and 1908 female. Statistical analysis used: Age Adjusted Rate (AAR), Crude Rate (CR) and Population pyramids are provided by NCRP-ICMR.Results: The relative proportion of head and neck cancers of total cancer cases registered in KUD constitutes 26% (654/2508) and 12% (225/1908) in male and female respectively. In males cancer of hypopharynx (AAR 14.7) was most common followed by tongue (AAR 9.4) and mouth (AAR 7.7). In females cancer of mouth (AAR 7.6) is most common followed by cancer of tongue (AAR 3.2).Conclusion: The pattern and incidence of various head and neck cancers is of utmost importance for primary prevention and early detection to adequately manage these cancers comprehensively in the community.

Tobacco smoking as risk factor of laryngeal cancer

Introduction: Laryngeal cancer is one of the most common type of head and neck cancers. It develops due to spontaneous mutation or influence of external factors (physical, biological and chemical). Cigarette smoking is primary chemical risk factor of laryngeal cancers. Purpose: The aim of the review was to present a role of tobacco smoking in the causation of laryngeal cancer. State of knowledge: Many of studies performed past years confirmed the correlation between tobacco addiction and head and neck cancers. 75% of all head and neck cancers are caused by cigarette smoking, which contains thousands of chemicals. More than 60 of them are known as carcinogens. Summary: Laryngeal cancer is the most common head and neck cancer. The prevalence of laryngeal cancer is increased by several carcinogens including tobacco smoking, which is known as the major risk factor of this type of cancers