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.