Retrospective Incidence Analysis of Head and Neck Cancer Patients in Rural Areas of Sindh, Pakistan

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Background: Head and neck cancer is the most common malignancy in Sindh, Pakistan. The type of cancer can be observed in the oral cavity, lips, buccal mucosa, oropharynx, hypopharynx, nasopharynx, the floor of the mouth and hard palate in Sindh. Objectives: The present study was conducted at the Nuclear Medicine Oncology and Radiotherapy Institute Nawabshah (NORIN), Sindh, with the objective of reviewing descriptive epidemiological characteristics and incidence of head and neck cancer in this rural area. Methods: In this study, we divided head and neck cancer patients according to their gender, age, districts, tumor location, probable causative agents, and stage of cancer when they had been admitted to the Radiotherapy Department of NORIN. Results: In total, 1,030 patients were registered during the study period from January 2012 to December 2016, comprising 56% males and 44% females. The most common site of the head and neck tumors was the oral cavity (58%), followed by the tongue, tonsil, floor of the mouth, gum, hard palate, soft palate, and lips. Other sites of head and neck cancer were hypo-pharynx, nasopharynx, salivary gland, parotid gland, oral-pharynx, and lyrnx. Most patients came in NORIN at stage III and stage IV of their disease and most of them were at the age of 40 - 85 years. Most patients were the residents of Nawabshah and neighboring districts. Conclusions: Head and neck malignancy was the most common type of cancer registered in NORIN in the last five years. Because of the lack of awareness, education, and diagnostic facilities, most patients start cancer treatment at later stages of the disease, which makes it very difficult to cure. Smoking and the use of alcohol, Gutka, Supari, Naswar, Man-Pori, etc., are the main causes of head and neck cancer.