Early detection of head and neck cancer

Abstract

In the United States, 42,000 new cases of cancers of the head and neck are diagnosed each year, usually at an advanced local or regional stage. Some 30,000, including most lip cancers, occur in the buccal cavity and oral pharynx. For patients with cancers of the buccal cavity and pharynx, the five-year survival rate ranges from 20% to 40%, correlates strongly with stage at diagnosis, and has not improved in the past 30 years. The other 12,000 occur in the larynx; for these patients the five-year survival rate has improved in the past 30 years from 50% to 65%. Lip cancers are rarely a cause of mortality; the five-year survival rate is 85%. For patients with advanced local head and neck cancers, the morbidity from the cancer and from treatment is very high and affects appearance, speech, eating, and breathing. Nevertheless, no lethal disease is easier to cure than oral cancer less than 1 cm in diameter (according to Arthur Mashberg of the Veterans Administration Medical Center, East Orange, N.J., a pioneer in the early detection of oral cancer). This article discusses when and in whom to suspect early cancers of the head and neck.