The incidence of a number of cancers is affected by socio‐economic status. We hypothesized that the incidence of head and neck squamous cell carcinoma (HNSCC) would fall with increasing affluence, that this pattern would be similar for all sites, and that more second primary tumours would appear in deprived groups.
Data on all HNSCC registered between 1985 and 1991 in the South West of England was collected. Tumours of the lip and skin were excluded. The measure of socio‐economic status chosen was the Carstairs Index.1 Tumours were classified as ‘first alone’, ‘first plus others’, ‘synchronous’ (within 60 days) or ‘subsequent’. Corrected χ2 testing was applied.
There were 1570 cases of HNSCC, 72% in men, 28% in women. Carstairs index could be determined for 1467 cases. Overall, socio‐economic status was inversely related to the development of HNSCC. In men, the most deprived group had a significantly higher incidence of oral carcinoma than all other groups (P < 0.01), whereas the incidence of laryngeal carcinoma showed a gradual rise with increasing deprivation. In women, the trend was less clear. Seventy‐two (4.9%) went on to develop a second primary, of which 35% were lung and 12% bladder. Socio‐economic status did not affect the development of a second primary tumour in either sex.
Thus, in the South West of England, socio‐economic status affects the incidence of HNSCC, but there are different patterns in different tumour sites. However, socio‐economic status does not affect the incidence of a second primary. The association of HNSCC with carcinoma of the bladder is a new finding.
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