New SurveyReveals That
Awareness of One of the World’s Most Common Cancers ‘Head and Neck Cancer’ is
Worryingly Low

General public not aware of symptoms and risk factors of head and neck cancer highlighting the need for more education to ensure better diagnosis and treatment of the devastating disease.

Barcelona, February 26, 2009 – Results from a European-wide survey(1) investigating public awareness of head and neck cancer were announced today at the International Conference on Innovative Approaches in Head & Neck Oncology (ICHNO), and revealed that despite being the sixth most common cancer worldwide(2), a staggering 75% of survey respondents were not aware of the term ‘head and neck cancer’(1). The ‘About Face’ survey backed by the European Head and Neck Cancer Society (EHNS) also identified alarmingly low levels of knowledge about head and neck cancer including the numbers of people with the condition, its symptoms and risk factors and the parts of the body affected(1). As a cancer type that is on the rise globally, affecting 143,000 people in Europe and leading to 68,000 deaths per year in Europe(3), these new survey findings highlight that more needs to be done to educate the general public about head and neck cancer to avoid delays in diagnosis and treatment.

Head and neck cancer occurs in the cells that cover or line the tissues and organs in the head and neck region including the oral cavity, pharynx, larynx and nasal cavities. Cancers in these regions are associated with high mortality rates and have a higher proportion of deaths per number of cases than common cancers such as breast cancer, cervical cancer or melanomas.4 Furthermore head and neck cancer is difficult to treat if the disease has progressed to an advanced stage by the time the patient presents, and patients may also suffer from secondary tumors and other co-morbid conditions(5).

“The ‘About Face’ survey results confirms our belief that more needs to be done to raise the profile of head and neck cancer,” commented Professor Jean-Louis Lefebvre, Chairman of the EHNS and Professor of ENT and Head and Neck Surgery, Centre Oscar Lambert, Lille, France. “Many of the symptoms of head and neck cancer are non-specific and are therefore frequently ignored by patients. As more than 60% of head and neck cancer patients are treated at the locally-advanced stage of the disease, significant improvements in symptom identification would be beneficial to patients and healthcare providers to ensure as many people can be diagnosed and treated as soon as possible.”

Underestimation of the incidence

Despite the numbers of people affected by head and neck cancer in Europe, the survey found that 20% of respondents believed head and neck cancer affected fewer than 1,000 people in Europe, equating to one hundred times less than the correct figure and indicative of how the impact of the condition is underestimated. Less than 1 in 3 correctly identified that head and neck cancer currently affects clearly more than 100,000 people in Europe.

Knowledge gap – symptoms, parts of body affected and risk factors

Overall the majority of symptoms were recognized by those surveyed but some of the less obvious symptoms were not identified and others incorrectly identified. Symptoms such as a lump in the neck, pain when swallowing and hoarseness/change in voice were identified by over half of the survey participants. However, less obvious symptoms including a persistent blocked nose or earache were identified only by a very small percentage of respondents, 14% and 18% respectively, and hearing loss was incorrectly cited by 21% of respondents as being related to head and neck cancer.

Furthermore while the majority of people recognized that head and neck cancer affects the pharynx and larynx, over half (60%) incorrectly believed it affects the brain.

Interestingly, this perception was also shared by 57% of respondents who work in healthcare professions, pointing to a tendency to assume all organs in that region of the body must be included as part of ‘head and neck cancer’. Other incorrectly identified body parts included the esophagus and eyes.

Three quarters of those surveyed realized that certain lifestyle factors increased the risk of developing head and neck cancer, but this was limited to the obvious risk factors of smoking and heavy alcohol consumption. Knowledge of some of the lesser known risk factors was low – 70% of people were not aware that sun exposure and being over 40 increased the risk of developing head and neck cancer and only 15% recognized that the human papillomavirus (HPV) could have an impact on the likelihood of developing the condition.

Josef van der Poel, a 64 year old patient from Belgium said “My head and neck cancer started with a simple sore throat, something you have as part of a common cold. I also did not fit any of the classic risk factor groups because I had never smoked or drunk alcohol excessively, so early recognition was vital in my case as my cancer could have gone undetected until it was too late.”

Treatment of head and neck cancer depends on the stage and location of disease and the overall health of the patient. Patients with early disease are treated by either surgery or radiation therapy. Patients with advanced disease receive a combination of different treatments including surgical removal, radiation therapy and chemotherapy. Patients with tumors that cannot be surgically removed may receive radiotherapy alone or in combination with chemotherapy or in combination with a targeted therapy which specifically targets and destroys tumor cells. When the disease is recurrent and/or metastatic several treatment options are available including chemotherapy alone or combined with a targeted therapy, and the best supportive care.

“Head and neck cancer affects people of all ages and backgrounds and I urge anyone worried by symptoms to make an appointment with their doctor. Similarly healthcare professionals who may be seeing patients with a wide range of symptoms and disease risk factors play a valuable role in ensuring earlier symptom recognition, treatment and diagnosis,” stated Professor Jan Vermorken, Antwerp University Hospital, Belgium.

February, 26, 2009

The ‘About Face’ survey was conducted across seven European countries: France, Germany, Italy, Netherlands, Spain, Sweden and the UK with 7,520 responses collected. The data and analysis was conducted by TNS Healthcare, with support from the European Head and Neck Society (EHNS) and funding from Merck KGaA.

References:
1. ‘About Face’ Head and Neck Cancer Awareness EU Omnibus Survey, TNS Healthcare
2. Hunter KD, et al. Nat Rev Cancer 2005;Feb;5(2):127-35
3. GLOBOCAN 2002 (www-dep.iarc.fr), accessed December 2008
4. The International Academy of Oral Oncology (http://www.eastman.ucl.ac.uk/iaoo/, last accessed December 2008)
5. Forastiere A, et al. N Engl J Med 2001;345(26):1890-1900.
For more information on Squamous Cell Carcinoma of the Head and Neck (SCCHN) please visit: http://www.globalcancernews.com/.