The QLQ-H&N35, in conjunction with the QLQ-C30, provides a valuable tool for the assessment of health-related quality of life in clinical studies of H&N cancer patients before, during, and after treatment with radiotherapy, surgery, or chemotherapy.

selected exogenous agents in the etiology of head and neck cancer. The factors studied were tobacco smoking, alcohol intake, the use of moist oral snuff, dietary

Detailed knowledge about the differences between groups and changes over time may aid us in the communication with patients and in the design of intervention studies focusing on improvement of the support and rehabilitation of patients with head and neck cancer.

Summary A Swedish/Norwegian head and neck cancer study was designed to assess prospectively the levels of mental distress and psychiatric morbidity in a heterogeneous sample of newly diagnosed head and neck cancer patients. A total of 357 patients were included. The mean age was 63 years, and 72% were males. The patients were asked to answer the HAD scale (the Hospital Anxiety and Depression scale) six times during 1 year. The number of possible or probable cases of anxiety or depression disorder was calculated according to standardized cut-offs. Approximately one-third of the patients scored as a possible or probable case of a major mood disorder at each measurement point during the study year. There were new cases of anxiety or depression at each time point. The anxiety level was highest at diagnosis, while depression was most common during treatment. Females were more anxious than males at diagnosis, and patients under 65 years of age scored higher than those over 65. Patients with lower performance status and more advanced disease reported higher levels of mental distress and more often scored as a probable or possible cases of psychiatric disorder. Our psychometric analyses supported the two-dimensional structure and stability of the HAD scale. The HAD scale seems to be the method of choice for getting valid information about the probability of mood disorder in head and neck cancer populations. The prevalence of psychiatric morbidity found in this study emphasizes the importance of improved diagnosis and treatment.

The chosen questionnaires differentiated between different sites of head and neck cancer at diagnosis. Tumor stage had the most powerful impact on HQL score.

In several countries, increased incidence of squamous cell carcinoma (SCC) of the tongue in young adults has been suspected during the last decades. Some reports indicate a lower survival rate for young patients compared to older patients. In other reports, there has not been any considerable difference in survival when comparing young adults to older patients, whereas some authors have shown better survival for young adults. This disease is rare in young adults, and early reports were based on comparable small numbers and selected patients. Our aim was first to perform a population-based study to determine if an increased incidence in SCC of the tongue could be verified in a larger population comprising the Scandinavian countries Denmark, Finland, Sweden and Norway. A second aim was to determine survival rates for young adults compared to older patients. The material was based on the annual cancer incidence and survival reports from the Scandinavian cancer registries. The study period was 1960 -1994. During that period, 5,024 SCCs of the tongue were reported. Of these, 276 (5.5%) were young adults (20 -39 years). The incidence increased at all ages except for women 65-79 years old. The increase was most pronounced in young adults: 0.06 -0.32 for men and 0.03-0.19 for women, counted by 100,000 person-years. Relative survival was significantly better for young adults compared to older patients.

Metastatic disease in the thyroid gland is uncommon in clinical practice. Preoperative investigation with thyroid scan and fine-needle aspiration biopsy verified or strongly suggested metastatic disease in seven out of nine patients. All patients were treated by thyroid surgery. Three patients died within 4 months in disseminated disease. The remaining seven patients had a survival rate of between 1 and 5 years. Three patients are still alive 12, 29, and 48 months after thyroid surgery. Surgical treatment for metastatic disease in the thyroid, especially due to metastatic renal carcinoma and melanoma, is recommended.

Background The aim of the study was to analyze whether there were any changes in incidence and prognosis of hypopharyngeal carcinomas diagnosed between 1960 and 1989 in Sweden. Methods Data of primary hypopharyngeal malignant tumors reported to the Swedish Cancer Registry were collected. The total number of cases was 2012, 1396 men and 616 women, and the end of follow‐up was December 31, 1992. Results For women, a significant decrease in the age‐standardized incidence (ASI) was seen, with an average decrease of 2% per year (p < .001), which was most evident in rural counties. The male patients, on the contrary, showed a significant increase of about 1.5% per year (p < .001); the metropolitan areas had an ASI about twice that of more‐rural areas. The 2‐ and 5‐year overall survival was poor, only 25% and 13%, respectively. For women aged <60 years, no difference in survival between the different 10‐year periods was seen, but survival for men of corresponding ages improved significantly (p < .01) during the last decade, to reach a survival similar to that in women. For patients aged ≥60 years, no difference in survival between the different periods or between sexes was seen. Conclusion The increased incidence in hypopharyngeal cancer in men is similar to that observed for oral and pharyngeal cancer in many European countries during this period. The disappearance of Plummer‐Vinson syndrome may explain the decreased incidence among women. The treatment results in hypopharyngeal cancer are still very poor, and improvements of the therapeutic methods are needed. © 1998 John Wiley & Sons, Inc. Head Neck 20: 714–719, 1998.