Head and neck cancer
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Head and Neck Cancer in Al-Qassim Dr. Shad Salim Akhtar MBBS, MD, FRCP(Edin), MAFUICC Consultant Medical Oncologist Prince Faisal Oncology Center
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Transcript of Head and neck cancer
Head and Neck Cancer in
Al-Qassim
Dr. Shad Salim AkhtarMBBS, MD, FRCP(Edin), MAFUICC
Consultant Medical OncologistPrince Faisal Oncology CenterKing Fahd Specialist Hospital,Buraidah, Al-Qassim
CollaboratorsDept of ENT
Dr. Fadl A FadlDr. Nooreni MA Oyetungi
Prince Faisal Oncology CenterDr. Imran-ul-Haq (Histopathology)Dr. Yasser (Histopathology)Ms Lolita M Reyes (Histopathology)Dr. Farhat A KhanMrs. Rosily Patsy (Oncology Nurse Specialist)Mrs. Masoodeh Keivan (Cancer Reg Office)Ms. Elaina (CME)
Head & Neck Cancer-definition
• Specific anatomical sites– Oral cavity– Pharynx– Nasopharynx– Larynx– Nose/sinuses– Salivary glands– Temporal bone & neck
• Squamous cell carcinoma (~60-90%)
• Period of study 1987-2000• Pathology data 87-1993• NCR data 1994-2000• All H/P confirmed at H&N sites included• Exclusions
– Lymphoma– Unknown primary– Thyroid– Skin
Head & Neck Ca- Al-Qassim
Head & Neck Ca-Al-Qassim-relative frequency
Other sites
Head & neck 6.7% of
all sites
M:F ratio
92:43
2.2:1
1875
135
All cases=2010
Head & Neck Ca- frequency
• USA 3.5% (SEER data)
• KSA 7.5% (NCR data (94-96))
KSA published series– KFSH&RC 10.6% (Mehboobi E: ASM 1987)
– Al-Qassim 6.9% (Akhtar SS: ASM 1997)
– Asir 9.6% (Al-Ghamdi S : ASM 1994)
– Al-Baha 9% (Willen R: SMJ 1989)
Head & Neck Ca-Al-Qassim-age distribution
213
1222
2723
2010
6
<11
11-20
21-30
31-40
41-50
51-60
61-70
71-80
>80
Mean=48.79 (+11.25) Range=7-90
Male=50.55 (+19.3) Females=45 (+18.65)
68% pts
25%
H & N Ca -NCR 94-96- site vs regions
Ry Naj Eas Mak Nor J ez Ha Mad Bah Tab Asr J ou Qas
Sal gl
Larynx
N/Sin
Pharyn
Hypoph
Nasoph
Oroph
Mouth
Gum
Tong
Lip
10.412.9
19.1
3.7
8.4
3.6
27.7
5.68.6
40
20
30
10
2.6
12
15.89
30.5
8.4
4.5
14.7
45.9
17.2
21
31
67.5
5.26.7
USA Europe KSA(NCR) KSA RMC
LipTongOralNasophPharyN/SinLarynxSalivOther
Head & Neck Ca-Al-Qassim-epidemiology
Head & neck ca-Al-Qassim-sites
2
12 9 7 7
67
8 313
7
LipTongueMouthPalateSal glNasophyPharynxNose/SinLarynxOthers
Head & Neck Ca-Al-Qassim-epidemiology
0
10
20
30
40
50
USA Europe KSA(NCR) KSA RMC AL-Qassim
Lip Tong Oral Nasoph Phary N/Sin Larynx Saliv Other
Head & neck ca-Al-Qassim- site vs sex
20 8
454
34
34
47
20
2111
2
104
L ip Tong Mouth Palate SalGl Nasoph No/S Larynx Other
Male Female
Highest M:F
Head & neck ca-Al-Qassim-histology
63
37
14
21
OthersNOSUndiffSq CC
RMC 50.7% USA 88.6% Nigeria 75%Sudan 67%Egypt 85%
AlcoholTobaccoPoor OD hygieneIonising radiation
Head & nek ca-Al-Qassim-grade
10 39
19
94
Well diff Mod diff Poor diff Undiff Unk
Head & neck ca-Al-Qassim-extent
2013 13
73
79
Local Region LN Reg+LN Distant Unk
64%
42%
Nasopharyngeal Ca-Al-Qassim-histology
5 4
24
911
63
0
41
NOS Undiff Sq Lymep Other
MaleFemale
Male:Female::42:20 (2:1)
Mean age 43.7 (+17.8) M=44.8 (+18.25) F=41(16.4)
EBVFam clusteringDietary factorsLess veg/fruitsDomestic smoke
55
68
12
UnknownSaudisNon Saudi
Head & neck ca-Al-Qassim-nationality
Head & neck ca-Al-Qassim-no/yr
2
106 7 8
6 79
16
811
19
1214
0
5
10
15
20
87 88 89 90 91 92 93 94 95 96 97 98 99 2000
Pt Number
Year of diagnosis
• Head neck cancer common • SCC is the commonest histology• Nasopharynx commonest site
– Undifferentiated histology– Other etiological factors?
• The majority present in advances stage• Incidence may be increasing??
Head & neck ca-Al-Qassim-conclusions
