Africa: A window on challenges and opportunities for head and neck cancer

Abstract

Background Head and neck cancer occurs predominantly in the Developing World, with significant challenges relating to a high burden of disease, late presentation, and poor access to curative and palliative care. Aims This article describes challenges relating to head and neck cancer care in Sub‐Saharan Africa. Material & Methods Educational and training innovations that have been undertaken to improve access to cancer care are presented under the following headings: Open Access Educational Resources African Head and Neck Society (AfHNS); African head and neck surgery fellowship training; AfHNS Virtual Tumor Board; The AfHNS Clinical Practice Guidelines for Head & Neck Cancers in Developing Countries and Limited Resource Settings. Concerns are also raised about universally applicable cancer staging systems. Results The challenges facing African patients apply to equally to many other parts of the developing world. Discussion The challenges facing African patients apply to equally to many other parts of the developing world. Conclusions For outcomes of head and neck cancers to be improved globally, a far greater investment needs to be made in education and training to improve access to care in developing countries. To make a meaningful global impact on morbidity and mortality related to HNC, clinicians, academic institutions and professional societies in developed countries need to be sensitive to these developing world challenges and should directly engage in improving access to care through promoting open access educational resources, offering specialist and fellowship training, collaborating with appropriate research, and establishing and strengthening centers of excellence in developing countries. Level of Evidence 2c “Outcomes research”.

Delphi Method Consensus on Priority Global Otolaryngology–Head and Neck Surgery Conditions and Procedures

“…For example, no head and neck cancers were included in the final list, possibly because they are detected and treated late in the disease course in many settings. Patients more commonly present with acute sequelae, such as airway obstruction or a neck mass, which were on the list of priority conditions 23‐25 . Another possible explanation is that our study asked participants to rank different types of head and neck cancers separately because of their distinct epidemiology, treatment approaches, and outcomes ( Table 8 ).…”

“…Patients more commonly present with acute sequelae, such as airway obstruction or a neck mass, which were on the list of priority conditions. [23][24][25] Another possible explanation is that our study asked participants to rank different types of head and neck cancers separately because of their distinct epidemiology, treatment approaches, and outcomes (Table 8). Together head and neck cancers are known to contribute significantly to global morbidity and mortality.…”

“…This is the first study seeking international consensus on global priority OHNS conditions and procedures. Amid power imbalances in global health research, research priorities in LMICs are often overshadowed by those from HICs 24 . Yet, LMIC providers are uniquely positioned to best understand their local burden of disease, patient population, and local and regional factors that affect care 33,34 .…”

“…Amid power imbalances in global health research, research priorities in LMICs are often overshadowed by those from HICs. 24 Yet, LMIC providers are uniquely positioned to best understand their local burden of disease, patient population, and local and regional factors that affect care. 33,34 To ensure the inclusion of local and regional expertise in this Delphi method survey, each World Bank region was represented by a minimum of 1 survey participant.…”

Esophageal and Head and Neck Cancer Patients Attending Ocean Road Cancer Institute in Tanzania from 2019 to 2021: An Observational Study

“…Head and neck cancers are the sixth most common cancer type worldwide, with an incidence per year of 550,000–690,000 and an annual mortality of 300,000–450,000 [ 6 , 7 , 8 , 9 , 10 ]. Almost 67% of the new cases and 82% of the mortality due to head and neck cancers occur in developing countries [ 11 , 12 ]. Hospital data from Tanzania show that head and neck contributes to 7% of all cancer cases [ 5 ].…”