Clinical reviewSquamous cell carcinomas of the head and neckCommentary: Head and neck carcinomas in the developing world

doi:10.1136/bmj.325.7368.822

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Squamous cell carcinomas of the head and neck

R J Sanderson, consultant otolaryngologist (sandtol@ukgateway.net),
J A D Ironside, consultant clinical oncologist

Edinburgh Cancer Centre, Western General Hospital, Edinburgh EH4 2XU
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China

Correspondence to: R Sanderson

Accepted 24 July 2002

Public awareness of this common form of cancer needs to be increased because despite important advances in treatment, prognosis still largely depends on the stage of presentation

More than 90% of tumours in the head and neck are squamous carcinomas. Cancer of the head and neck, which can arise in several places, is often preventable, and if diagnosed early is usually curable. Unfortunately, patients often present with advanced disease that is incurable or requires aggressive treatment, which leaves them functionally disabled. We have reviewed current practice and potential future advances in the referral, diagnosis, and management of head and neck cancer.

Summary points

Squamous cell cancer of the head and neck is common worldwide (4% of all cancers in the United States; 5% in the United Kingdom)
The prognosis for early stage disease is good, but for patients with advanced disease it has altered little in the past 20 years
Multidisciplinary teams are essential for optimum management
Combinations of treatments can offer preservation of organs and function
Improved reporting of morbidity and quality of life is essential
Increased public awareness about the association with smoking and alcohol and the importance of early detection is needed

Methods

We gathered information from several sources, including personal experience of treating head and neck cancer in a multidisciplinary tertiary referral centre and the Medline and Cochrane databases.

Incidence

Squamous cell cancer of the head and neck is one of the most common cancers worldwide, with incidences of more than 30 per 100 000 population in India (oral cancer) and in France and Hong Kong (nasopharyngeal cancer). It constitutes about 4% of all cancers in the United States and 5% in the United Kingdom. A total of 2940 new cases of lip, mouth, and pharyngeal cancer in men were reported in the United Kingdom in 1996: an incidence of …

Correspondence to: W Wei