Risk factor profiles of head and neck cancer patients of Andhra Pradesh, India

Objective: To define the demographic risk profile and stage at diagnosis among the head and neck cancer (HNC) patients reported in two hospital-based cancer registries in Andhra Pradesh. Materials and Methods: A cross-sectional study was conducted in patients with histologically confirmed diagnosis of squamous cell carcinoma of the head and neck during 2002-2006. Data on the demographic profile and clinical information were obtained from hospital and clinical records. Staging was based on the American Joint Committee on Cancer and included primary tumor size (T), regional neck status (N), and group stage. The site of cancer was classified based on the International Classification of Disease for oncology (ICD-02). Results: A total of 5458 cases of HNC were included in this study. Majority of the subjects were in the age range of 40-69 years with a significant male preponderance in all the age groups (P<0.001). The most common habit was the combination of smoking, alcohol, and chewing in both males and females (20.1 and 35.1%, respectively) (P<0.001). Tongue and buccal mucosa were the most common sites of cancer in both males (26.8 and 12.8%, respectively) and females (22.9 and 19.8%, respectively) (P<0.001). Tongue was the commonest site of cancer occurrence with respect to all the habits (both singly and in combination) except for chewing tobacco where buccal mucosa was the most common site. Males were more likely to be diagnosed in stage 3 (37.6%) and 4 (20.6%), while females were diagnosed in stage 1 (36.3%) and 2 (32.7%) (P<0.001). Conclusion: A male preponderance of cancer occurrence and combination of all the three habits (smoking, alcohol, and chewing) were found to be the significant risk factors. Males were more likely to be diagnosed later than females.