ABSTRACT

Each year in the UK there are 8000 cases of head and neck cancer leading to a total of 2500 deaths per annum. Nearly 90 per cent arise in the over-50s, the incidence increasing with age, and there is a strong male predominance with a male to female ratio of 2:1 for oral cancer and 5:1 for laryngeal cancer. Incidence rates vary greatly from region to region within each country, and the incidence and mortality rates are increasing. Worldwide, the highest incidence is in India and Sri Lanka where in some areas they are the most common cancers, constituting up to 40 per cent of the total. Other pockets of high incidence include South America and the Bas-Rhin region of France (oral cancer), and Newfoundland (lip). The head and neck contain the origins of the respiratory and gastro - intestinal tracts, both of which are exposed to environmental carcinogens through the air we breathe and the food and drink we ingest. Each site will be dealt with individually, although cancer of the oral cavity will be described in detail as many of the basic principles are applicable to head and neck cancer in general. As a general rule, the prognosis worsens as the tumour site moves further down the aerodigestive tract from the lips.