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Chapter 1 - Epidemiology, Risk factors and Pathogenesis of Squamous Cell Tumours

Survival in HNSCC is predicted primarily by anatomical site, stage and HPV status, with other pathological and clinical factors influencing prognosis to a lesser degree.

In the recent EUROCARE population-based study, 5-year relative survival was poorest for hypopharyngeal cancer (25%) and highest for laryngeal cancer (59%).

For oral cavity and pharyngeal cancer, 31% of cases are localised at the time of diagnosis. For laryngeal cancer, 55% of patients are diagnosed with localised disease

For oral cavity and pharyngeal cancer, 5-year survival rates have increased from 57% in 1992 to 65.1% in 2003. Death rates have not changed over 2003–2012.

For cancer of the larynx, 5-year survival rates have not changed significantly over the past 30 years. 

The survival improvement is greatest for tonsil cancer (39.7% to 69.8%). This trend is attributed to HPV-positive tumour status, which is a strong predictor for survival.

High cure rates are reported for localised and locoregional disease. However, the 3-year survival rate does not exceed 40% in a subset of patients with localised HNSCC.

HPV-positive oropharyngeal cancer (OPC) patients show better response to treatment, and survival is improved by approximately 50%. Improvement in survival is reduced in smokers.

Despite advances in multimodality treatment, survival rates for recurrent/metastatic disease remain dismal.

Revision Questions

  1. What is the 5-year survival rate of head and neck cancer in Europe by anatomical site?
  2. What is the trend of survival rates for oral cavity and pharyngeal cancer and cancer of the larynx in the past 20 years?
  3. What is the 3-year survival rate of head and neck cancer according to stage?
1 - Epidemiology Risk factors: Squamous Cell Tumours Risk Factors

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