Improved survival of head and neck cancer patients in Greenland

Abstract

Previously, head and neck cancer (HNC) patients in Greenland have had significant diagnostic delay and poor survival rates. From 2005-2009 several initiatives have been made to ensure faster diagnosis and better survival. The aim of this study was to compare the prognosis before and after these initiatives were introduced.All Greenlandic patients diagnosed with HNC between 2005 and 2012 were included. Data were retrieved from medical records and national databases and compared with the period 1994-2003. A total of 98 patients were identified. Diagnostic delay was significantly lower compared to the period 1994–2004 (p=0.048). The 3-year overall survival was 56% for all HNC and 47% for nasopharyngeal carcinomas. We found that patients with HNC between 1994 and 2003 had a higher risk of death from all reasons compared with the period 2005–2012 (HR 2.17; CI 1.46–3.23) after adjustments for stage and diagnostic delay.Patients with head HNC in Greenland from 2005-2012 were diagnosed earlier and had a better overall survival compared to the period 1994–2003. The change in survival is more likely to be due to improvement in treatment rather than the initiated interventions. Although survival has improved in Greenland, demographic problems and lack of specialists remain a challenge.

Incidence and survival of head and neck cancer in the Faroe Islands

“…Laryngeal cancer had the highest ASIR among Faroese men while thyroid gland cancer had the highest ASIR among Faroese women. Similar findings are also confirmed in other studies [ 3 , 26 , 30 ]. The biggest difference between Faroese and Danish HNC patients was for men with oral cavity cancer and OPC with a noticeably higher ASIR for Danish male HNC patients.…”

“…Our study showed that the ASIR for all HNC was higher among men than women. Similar trends are seen in other Nordic studies [26][27][28][29][30]. Laryngeal cancer had the highest ASIR among Faroese men while thyroid gland cancer had the highest ASIR among Faroese women.…”

“…The vast majority of both countries’ HNC patients receive treatment at RH. However, our results showed that diagnostic and treatment timelines were shorter for the Faroese HNC patients compared with the Greenlandic HNC patients [ 29 , 30 ]. More advanced cancer stages for Greenlandic HNC patients compared with Faroese HNC patients are also seen [ 30 ].…”

“…However, our results showed that diagnostic and treatment timelines were shorter for the Faroese HNC patients compared with the Greenlandic HNC patients [ 29 , 30 ]. More advanced cancer stages for Greenlandic HNC patients compared with Faroese HNC patients are also seen [ 30 ]. One reason could be that frequent follow-up of HNC patients at ENT doctors or oncologists is an even greater challenge in Greenland due to the demographic structure with scattered communities far from the regional health centres [ 30 ].…”

“…More advanced cancer stages for Greenlandic HNC patients compared with Faroese HNC patients are also seen [ 30 ]. One reason could be that frequent follow-up of HNC patients at ENT doctors or oncologists is an even greater challenge in Greenland due to the demographic structure with scattered communities far from the regional health centres [ 30 ]. Also, the three countries have different health care procedures and health legislation; the Danish fast-track programme is, e.g.…”