Diagnosis and management of head and neck cancers in a high-incidence area in France

Abstract

Head and neck cancers have a very poor prognosis and are common in France. They are subject to various recommendations for early detection and management, but there is no detailed data in the French general population to fuel the public health debate on it.A high-resolution population-based study about cancer management was conducted, using cancers registries in the north-west of France, on 1729 tumors diagnosed between 2008 and 2010.The tumors were diagnosed late (70.3% stage III–IV), mainly after the onset of symptoms (93.2%). After adjustment, advanced stages were more frequent in patients with hypopharyngeal [adjusted odds ratio (ORa): 4.68; 95% confidence interval [CI] 3.11–7.05] and oropharyngeal tumors (ORa: 2.84; 95% CI 2.02–3.99) compared with oral cavity ones. They were also more frequent in patients with moderate (ORa 1.68; 95% CI 1.12–2.52) or severe comorbidities (ORa 1.86; 95% CI: 1.23–2.80). A multidisciplinary meeting (MM) had taken place in 96.9% of cases. The assessment included a panendoscopy in 80.3% of cases, a cervical computerized tomography (CT) scan in 89.3% and a chest CT scan in 87.3%. The vast majority of patients (90.7%) had received treatment, with surgery in 48.7% of cases and/or radiotherapy in 76.9%.Despite the recommendations for early detection, diagnoses are often made late, even for tumors that can be detected by a direct visual and tactile examination of the oral cavity. However, the major risk of advanced stage concerns deep tumors and the most weakened subjects. Otherwise, diagnostic assessment is broadly consistent with the recommendations, and multidisciplinary treatment decisions are widespread.

Relationships between histogram analysis of ADC values and complex 18F-FDG-PET parameters in head and neck squamous cell carcinoma

“…Head and neck squamous cell carcinoma (HNSCC) is one of the most frequent malignancies [ 1 ]. Different imaging modalities like computed tomography (CT) and magnetic resonance tomography (MRI) are used for correct tumor staging in HNSCC [ 2 ].…”

Conhecimento de Universitários da Área da Saúde sobre o Câncer de Cavidade Oral

“…Silva 26 acrescenta que cabe aos profissionais realizarem um exame clínico detalhado para reconhecer e tratar as lesões, e conhecerem os exames complementares para um diagnóstico. Os encaminhamentos tardios são frequentes e são em razão do conhecimento e das habilidades inadequadas desses profissionais 27,28 .…”

“…Ainda que o câncer oral não seja o mais prevalente, tem um prognóstico de mortalidade e principalmente de morbidade nos pacientes, essencialmente quando descoberto tardiamente após o aparecimento dos sintomas 12,28 . O diagnóstico tardio, geralmente quando os tumores já estão mais profundos, possui a probabilidade de ter o estágio mais avançado da doença.…”

“…O diagnóstico tardio, geralmente quando os tumores já estão mais profundos, possui a probabilidade de ter o estágio mais avançado da doença. Nesses casos, comumente, os pacientes recebem o tratamento com cirurgia e radioterapia 28 , conforme os universitários demonstraram conhecimento, embora Canevese et al 20 tenham revelado que os indivíduos estudados demonstram não saber sobre a associação da cirurgia com os outros tratamentos.…”

Circulating Biomarkers in Patients with Head and Neck Cancer and the Influence of Cigarette Smoking

“…More advanced disease at diagnosis is generally associated with poorer survival prognosis (van der Schroeff et al, 2012). The majority of the HNC patients have an advanced disease at diagnosis (Guizard et al, 2017) mostly due to that HNC initially have diffuse symptoms such as sore throat, sinusitis or sores in the mouth and on lips that do not heal. Other factors affecting the survival are tumor location, co-morbidity, surgeon resection margins, treatments, immune suppression or if tumors in oropharynx is infected with HPV (Ang et al, 2010, Eldeeb et al, 2012, Hall et al, 2000, Lam et al, 2018, van der Schroeff et al, 2007, van der Schroeff et al, 2012.…”