Conclusion
It appears that the increasing incidence of HNC in Southern Africa is
mostly due to increasing smoking and drinking habits, and that HR-HPV
and HIV play a minor role in the development of HNC in this region.
Nevertheless, many countries in Africa are undergoing economic
modernization, resulting in major changes in lifestyle, diet and sexual
behaviour and in coming years we may observe an increasing incidence of
HPV-positive OPSCC. Furthermore, we have shown that SCC of the head and
neck in Southern Africa is predominantly a disease of older adult males
of lower socioeconomic status, who often present with locally advanced
disease, requiring palliative oncologic care. This calls for an urgent
adoption of HNC control programmes, that not only regulate the tobacco
and alcohol industries in this region but also address the social
inequalities and the high unemployment rate in this region, in the quest
to reduce the mortalities and morbidities associated with HNC.