Primary head and neck cancers in Jos, Nigeria: a re-visit

To document the pattern of primary head and neck cancers in Jos, Nigeria.

A record-based study of head and neck cancers histologically diagnosed at the Jos University Teaching Hospital (JUTH), Jos, between January 1987 and December 2002.

A total of 710 cases (over 44 cases per year) were diagnosed, with a rising trend. The most common sites for cancer were the eyes (15.4%), lymph nodes (12.4 %), thyroid gland (11.8%) and the oral cavity (7.6%). Carcinomas 432(60.8%), lymphomas 119(16.8%) and sarcomas 105(14.8%) were the commonly reported cancers. Carcinomas were most commonly reported in the thyroid gland (19.2%), oral cavity (10.2%) and the eyes (9.5%). AIDS-related cancers constituted 12.3% of all head and neck cancers and were commonly reported in the 3rd decade of life. This is higher than the 10.9% and 7.6% previously reported for Jos (p=0.89) and Maiduguri (p=0.034) respectively. Carcinomas were associated with alcohol use and tobacco smoking (p<0.001), while kaposi sarcoma was more associated with HIV-positive patients than squamous cell carcinoma (p=0.016). The duration of symptoms for cancers varied with sites and cancer type but ranged from 6.5-89.7 months (mean= 37.7 +/- 51.1 months). 59 (93.7%) of the staged cancers reported in the late stages (III & IV). 48 (43.2%) of the treated cancers had primary surgery, while most lymphomas were treated with primary chemotherapy.

There is a rising trend in the occurrence of head and neck cancers in Jos, with a considerable proportion of the patients being below 30 years. The late presentation of patients, late stage at presentation, the rising profile of HIV/AIDS in the area and the non-availability of relevant specialists in the hospital could adversely affect the prognosis of these cancers.