Oropharyngeal and not oral cavity cancers form the major head-and-neck cancer burden in North Haryana: A retrospective observational study from a rural comprehensive cancer center

Abstract

Background: Head-and-neck cancers (HNCs) originate at multiple subsites with varying epidemiology and clinical profiles across India. Objectives: This study aimed to explore the demographic and clinico-epidemiologic profiles of patients with HNC at our institution. Materials and Methods: This retrospective observational study was conducted on the case records of all patients with HNC who were registered between January 2018 and December 2020 at the Department of Radiation Oncology of Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, a comprehensive cancer center in rural Northern Haryana, India. Results: We enrolled 516 patients in the study. The mean age was 56 years (standard deviation (SD) 12.6), and the male-to-female ratio was 8.6:1. Smoking was reported by 413 (80%) patients, and smokeless tobacco use was reported by only 74 (14.3%) patients. Oropharyngeal cancer (178, 34.5%) was the most common site observed, and the base of tongue (112, 21.7%) was the most common subsite; oral cavity cancer was the second most common primary site, noted in 140 (27.1%) patients. This was contrary to global and national data, wherein oral cavity cancers are the most common. Most patients (226, 43.8%) presented with locally advanced disease, that is, Stage IVA. Conclusion: Oropharyngeal cancers are found in higher proportion when compared to oral cavity cancers in this belt of Northern Haryana and Northwestern Uttar Pradesh, owing perhaps to a higher level of smoking than tobacco chewing.

Keywords

• head-and-neck cancers
• human papillomavirus
• oral carcinoma
• oropharyngeal cancers
• tobacco