The burden of head and neck cancer in Africa: the status quo and research prospects

Abstract

The increasing incidence of head and neck cancer (HNC) in Africa is mostly due to increasing smoking habits, westernization in lifestyle and diet, HIV/HPV and unfavourable fiscal policies for health.Oral cancer potentially constitutes a notable fraction of the global cancer burden, particularly in developing Africa.A heterogeneity in the anatomy-based HNC nomenclature has resulted in underestimation of its incidence and significance worldwide.The global cancer statistics database (GLOBOCAN) was used to evaluate the combined data of cancer incidence in two subsets: a.) excluding HNC and b.) including oesophageal cancers (Upper Aerodigestive Tract Cancer: UADTC).Combined age standardized incidence rates (ASIR) of HNC and UADTC were analyzed using both regional and individual country-derived data.Frequency ranking of HNC in Africa increases dramatically when cancers from contiguous HN regions are evaluated, compared with considering oral cancer data alone.UADTC and HNC ranked second and third in Africa, respectively.Similar trends were observed by global development index evaluation.With the exclusion of a few urban regions, the diagnostic and treatment opportunities for HN/UADT cancers in sub-Saharan Africa are dismal.Effective education and research efforts by local and international (non-) governmental agencies are urgently required to reduce the associated morbidities.Oral cancer burden, Africa, research, HNC, UADTC Cancer is a major public health problem and a leading cause of death worldwide.It was estimated that between 1975 and 1990, there was a 37% increase in cancer cases with an annual growth rate of 2.1%.By the mid-nineties, over 10 million new cases were diagnosed with up to 6 million reported deaths.It is expected that this figure would have doubled by 2020. 1 Similar trends were observed in the GLOBOCAN 2008 database where approximately 60% mortality to incidence ratio was observed.It was also observed that 56% and 64% incidence and mortality figures respectively were reported in the developing world where cancer prognosis tends to be worse, due to late stage presentation, limited human resources and poorer infrastructure.2 Most recently, global cancer incidence and mortality figures were reported to be 14 and 8.3 million respectively, [3][4][5] showing a steady increase as earlier predicted.Oral cancer, which can be described as a malignant neoplasia originating in the oral cavity or on the lip, 6 ranks as the sixth most common cancer worldwide and as third in developing nations, with a high age standardized