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.