Head and neck cancers exhibit a continuous rising trend of prevalence and incidence rates across the globe and are more prevalent in developing nations like India, where they are responsible for a significant cancer-related mortality rate.
In India, head and neck cancers, particularly oral cavity cancers, cause over 125,000 deaths annually, accounting for a significant 30 per cent of all cancer cases as per the latest Global Cancer Observatory (GLOBOCAN) estimates produced by the International Agency for Research on Cancer (IARC) and disseminated as Cancer. Today on the GLOBOCAN website database. The GLOBOCAN 2024 database includes seven types of head and neck cancers, including lip and oral cavity, hypopharynx, nasopharynx, oropharynx, salivary gland, larynx, and thyroid cancer.
These categories are made according to the International Classification of Diseases Related Health Problems, 10th Revision (ICD-10), based on the anatomical location of the tumour. The estimated rise in the incidence rate was predicted until 2050. The highest prevalence was reported for lip and oral cavity cancer, which was 26.31, 17.07, and 6.4 for the 5 years, 3 years, and 1 year per 100,000 individuals, respectively.
The percentage risk of the rise of new cancer cases by the year 2050 is maximum for oropharynx cancer (103.9%). In India, the number of cancer cases is rising, and it is estimated that there will be approximately 2.1 million new cancer cases in India by 2040, an increase of 57.5% from the year 2020.
Tobacco addiction is one of the most significant risk factors for head and neck cancers, especially oral cavity cancers. Tobacco use has been identified as a risk factor in 80 to 90% of patients with oral cancer. Tobacco use in India is characterised by a high prevalence of combustible/smoked tobacco in the form of smoking cigarettes, beedis, hookah, and vapes, and smokeless tobacco use in the form of guthka, zarda, kaini, mishri, and mava being the most common forms, with dual use also contributing a noticeable proportion. Tobacco and alcohol consumption synergistically increase the likelihood of cancer by 500 times.
Oral cavity cancers can manifest with various symptoms depending on the location and stage of the cancer. Some common signs and symptoms include non-healing ulcers in the oral cavity, loosening of teeth, bleeding gums, excessive salivation, decreased mouth opening, swelling or lumps in the neck, pain, difficulty swallowing, changes in voice, persistent sore throat, ear pain, difficulty breathing, unexplained weight loss, bleeding, and numbness.
Oropharyngeal cancers, especially Human Papilloma Virus (HPV), are particularly on the rise, especially in the younger population (18 to 40 yrs.) owing to unprotected oral sex. Vaccination, along with safe sexual practices, is a promising mode of preventing such cancers.
Treatment for head and neck cancer typically involves a multidisciplinary approach, including surgery, radiation therapy, and chemotherapy, and in recent years, advancements in medical and precision oncology have led to targeted therapies and immunotherapy. Robotic surgery is a newer modality of treatment of head and neck cancers, reducing morbidity and hospital stay and improving functional and oncological outcomes.
One of the significant challenges in combating head and neck cancers in India is the late presentation of cases. Due to a lack of awareness, limited access to healthcare facilities in remote regions, and sociocultural beliefs, patients often seek medical help at advanced stages of the disease, reducing treatment options and chances of successful outcomes.
How can you prevent head and neck cancers?
Prevention is better than a cure. Head and neck cancers can be prevented by:
- Avoiding consumption of tobacco (in any form) and alcohol is the best strategy for oral and head and neck cancer prevention.
- Maintenance of good oral hygiene
- The HPV vaccine is now available, which helps in the prevention of HPV-associated oropharyngeal cancer.
- Regular screening
As healthcare stands poised on the edge of discovery, crucial innovations entail developing patient-focused and patient-friendly treatment modalities for head and neck cancers. Let us all take a pledge to unite together in our fight against head and neck cancers.