Primary head and neck cancers in North -Western Nigeria

Reported epidemiological studies on oro-facial cancers in Nigeria over the last four decades showed nonstandardized inclusion criteria and an overlap of study periods, resulting in conflicting findings.

To document the pattern of reportable primary head and neck cancers in North-Western Nigeria and analyse Methods: A review of both clinical and histopathology records of head and neck cancers diagnosed by histopathology at the ABUTH, Zaria, was undertaken. Socio-demographic information and history of cancer management, which followed the pattern of the Minimum Cancer Dataset developed by the British Association of Head and Neck Oncologists, were retrieved from pathology and medical records of patients diagnosed of cancers of the head and neck at the hospital from January 1972 to December 2002.

A total of 2611 cases were diagnosed, 730 (28%) occurred in children, 1775 (68%) in adults, with 64% occurring at or below 40 years of age. The eye, 564(21.6%) and the mouth, 251(9.6%) were the most commonly affected sites. Carcinomas (55%), lymphomas (23%) and retino-blastomas (10%) were the most common cancers. Cancers of viral origin constituted 18% of head and neck cancers and AIDS-defining cancers were 6%. A significant increase was noted in the occurrence of conjunctival squamous cell carinoma (SCC) and Non-Hodgkins Lymphoma NHL when comparing the periods pre- and post- advent of HIV/ AIDS in Nigeria in 1986. Comparing the two periods, there was a reduction in the ages of occurrence of conjunctival SCC; Non-Hodgkins Lymphoma (NHL), Kaposis sarcoma (KS) and nasopharyngeal carcinoma, a rise in the occurrence of nasopharyngeal carcinoma and a significant drop in the occurrence of Burkitt lymphoma.

Reduced age at presentation and the rising prevalence of several virus-associated cancers suggests the role of immuno-suppression in the pathogenesis of these cancers. Further studies into nutritional and viral epidemiology in the population are desirable as the implication for prevention and public health policies are profound.