Current evidence on the burden of head and neck cancers in Nigeria

BACKGROUND: Head and neck cancers (HNC) constitute 5–8% of total body cancers in Europe and America. It is difficult to appreciate the problem of cancers in Nigeria because most studies available are hospital-based studies. The aim of this study is to highlight current evidence on the burden of head and neck cancers in Nigeria based on literature review and to discuss potential health care actions to improve management. METHODS: A literature search using Medline was conducted for publications on head and neck cancer in Nigeria. Identified publications were manually searched for additional relevant non-Medline articles or abstracts. The full-texts of these articles were thoroughly examined for the occurrence, distribution, identified risks factors, presentations, diagnostic method, treatment, prognosis and challenges associated with the management of HNC. RESULTS: A total of twenty-seven relevant published articles on Head and neck cancers from 1968 to 2008 were reviewed. The age of patients with HNC ranged from nine months to over 80 years with peak between 3–6(th )decade of life. The male to female ratio ranged from 1:1 to 2.3:1. Identified risks factors were scanty, namely kola nuts and tobacco chewing, tobacco smoking, farming, viral infections, alcohol and smoking. Reports on the overall pattern of Head and neck cancers from different regions of the country cited nasopharynx as the commonest site for HNC, the sino-nasal is the second commonest while larynx, is the third commonly affected site. The majority of HNC was epithelial in origin and was mostly squamous cell carcinoma. Late presentation with advanced disease is common and treatment in most cases is palliative either with surgery or chemotherapy, and radiotherapy when available. There are few reports on the outcome of HNC treatment in Nigeria. CONCLUSION: The burden of managing HNC in Nigeria is enormous and the government should set up the National Cancer Institute with a view of educating the public on cancer prevention, detection and treatment.