Materiały źródłowe

• #1 Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10304137/

  Head and neck squamous cell carcinoma (HNSCC) is a group of malignancies, involving the oral cavity, pharynx, hypopharynx, larynx, nasal cavity, and salivary glands, that together compose the seventh most common cancer diagnosis worldwide. With 890,000 new cases and 450,000 deaths annually per GLOBOCAN estimates, HNSCC accounts for roughly 4.5% of cancer diagnoses and deaths. In the developing world, the incidence of HNSCC is growing with increasing consumption of tobacco (smoked or chewed), alcohol, and areca nut (betel quid). Alcohol and tobacco have a synergistic effect, with the heavy consumption of both increasing HNSCC risk 40-fold. […] The incidence and mortality rates of head and neck squamous cell carcinoma vary widely by geographic region and demographic characteristics. Globally, HNSCC is more common in men than in women, with a male-to-female ratio of approximately 2:1, and in adults over 50 years of age. The incidence rates of HNSCC are highest in South and Southeast Asia (where the chewing of the carcinogenic areca nut is prevalent)

• #2 Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37367741/

  Head and neck squamous cell carcinoma (HNSCC) is a group of malignancies, involving the oral cavity, pharynx, hypopharynx, larynx, nasal cavity, and salivary glands, that together compose the seventh most common cancer diagnosis worldwide. With 890,000 new cases and 450,000 deaths annually per GLOBOCAN estimates, HNSCC accounts for roughly 4.5% of cancer diagnoses and deaths. […] In the developing world, the incidence of HNSCC is growing with increasing consumption of tobacco (smoked or chewed), alcohol, and areca nut (betel quid). Alcohol and tobacco have a synergistic effect, with the heavy consumption of both increasing HNSCC risk 40-fold. […] In developed nations, HPV-related HNSCC surpasses tobacco- and alcohol-related disease. HPV-related HNSCC more commonly affects the oropharynx, hypopharynx, and larynx than the oral cavity, and is associated with a significantly longer median survival (130 months vs. 20 months).

• #3 Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma

  https://www.mdpi.com/2076-3271/11/2/42

  Head and neck squamous cell carcinoma (HNSCC) is a group of malignancies, involving the oral cavity, pharynx, hypopharynx, larynx, nasal cavity, and salivary glands, that together compose the seventh most common cancer diagnosis worldwide. With 890,000 new cases and 450,000 deaths annually per GLOBOCAN estimates, HNSCC accounts for roughly 4.5% of cancer diagnoses and deaths. […] The incidence and mortality rates of head and neck squamous cell carcinoma vary widely by geographic region and demographic characteristics. Globally, HNSCC is more common in men than in women, with a male-to-female ratio of approximately 2:1, and in adults over 50 years of age. […] The global incidence of head and neck squamous cell carcinoma has been increasing in many countries, particularly in younger populations, with a predicted 30% annual increase in incidence by 2030.

• #4 Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10304137/

  The global incidence of head and neck squamous cell carcinoma has been increasing in many countries, particularly in younger populations, with a predicted 30% annual increase in incidence by 2030. This trend is partly attributed to changes in lifestyle factors, such as increased alcohol consumption and tobacco use in developing nations, as well as the growing prevalence of human papillomavirus (HPV)-related oropharyngeal cancer. […] In the United States, per the SEER estimates, around 54,000 new cases of head and neck squamous cell carcinoma were diagnosed in 2022 (roughly 3% of all malignancies), with an estimated 11,230 deaths, accounting for roughly 2% of all cancer deaths. […] The incidence rates of HNSCC in the United States have declined overall by approximately 14% since 1975, largely due to decreases in tobacco use. However, since the nadir in 2003, incidence rates have increased by 15.5%. This growth has coincided with the replacement of tobacco-related HNSCC with HPV-related disease, with oropharyngeal disease set to surpass oral disease.

• #5 Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma

  https://www.mdpi.com/2076-3271/11/2/42

  In the United States, per the SEER estimates, around 54,000 new cases of head and neck squamous cell carcinoma were diagnosed in 2022 (roughly 3% of all malignancies), with an estimated 11,230 deaths, accounting for roughly 2% of all cancer deaths. […] The incidence rates of HNSCC in the United States have declined overall by approximately 14% since 1975, largely due to decreases in tobacco use. However, since the nadir in 2003, incidence rates have increased by 15.5%. […] The primary risk factors commonly linked to head and neck cancer encompass tobacco, alcohol consumption, using areca nut, human papillomavirus (HPV) infection (particularly for oropharyngeal cancers), and Epstein–Barr virus (EBV) infection (especially prevalent in Asia, particularly for nasopharyngeal cancers). […] The prevention of head and neck squamous cell carcinoma involves public health initiatives aimed at increasing oral screening and HPV vaccination, reducing exposure to tobacco, alcohol, and areca nut, and promoting a healthy lifestyle. […] To address the escalating burden of HNSCC, it is imperative to implement comprehensive public health interventions.

• #6 Head and neck cancer – Wikipedia

  https://en.wikipedia.org/wiki/Head_and_neck_cancer

  Globally, head and neck cancer accounts for 650,000 new cases of cancer and 330,000 deaths annually on average. In 2018, it was the seventh most common cancer worldwide, with 890,000 new cases documented and 450,000 people dying from the disease. […] The risk of developing head and neck cancer increases with age, especially after 50 years. Most people who do so are between 50 and 70 years old. […] In North America and Europe, the tumors usually arise from the oral cavity, oropharynx, or larynx, whereas nasopharyngeal cancer is more common in the Mediterranean countries and in the Far East. In Southeast China and Taiwan, head and neck cancer, specifically nasopharyngeal cancer, is the most common cause of death in young men. […] In the United States, head and neck cancer makes up 3% of all cancer cases (averaging 53,000 new diagnoses per year) and 1.5% of cancer deaths.

• #7 Epidemiology and risk factors for head and neck cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-head-and-neck-cancer

  Worldwide, head and neck cancer accounts for approximately 900,000 cases and over 400,000 deaths annually. In the United States, head and neck cancer accounts for approximately 71,100 cases annually and 16,100 deaths. In Europe, there were approximately 250,000 cases (an estimated 4 percent of the cancer incidence) and 63,500 deaths in 2012. […] Males are affected significantly more than females, with a ratio ranging from 2:1 to 4:1. The incidence rate in males exceeds 20 per 100,000 in regions of France, Hong Kong, the Indian subcontinent, Central and Eastern Europe, Spain, Italy, and Brazil, and among African Americans in the United States. Mouth and tongue cancers are more common in the Indian subcontinent, nasopharyngeal cancer is more common in Hong Kong, and pharyngeal and/or laryngeal cancers are more common in other populations; these factors contribute disproportionately to the overall cancer burden in these Asian countries.

• #8

  https://journals.lww.com/co-oncology/fulltext/2020/05000/epidemiology_of_head_and_neck_cancers__an_update.3.aspx

  This review attempts to give an update of epidemiological knowledge on head and neck cancers (HNC). […] Worldwide, from 1990 to 2017, incidence rates for larynx and nasopharyngeal cancers decreased, whereas they increased for oro/hypopharyngeal cancers and lip/oral cavity cancers. They are still markedly higher among men than women. South Asia has the highest HNC incidence rate, followed by Europe, North America, and Australasia. […] Tobacco and alcohol remain the major risk factors. Rate of cancers attributable to human papillomavirus (HPV) among HNCs is highly depending on world region and tobacco use prevalence. It increases in high-income countries. In the US population, the number of HPV-attributable oropharyngeal cancers now exceeds the number of cervix cancers. HPV vaccination for boys is recommended in an increasing number of countries.

• #9 Head and neck cancers incidence statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/head-and-neck-cancers/incidence

  Head and neck cancer is the 8th most common cancer in the UK, accounting for 3% of all new cancer cases (2017-2019). […] In females in the UK, head and neck cancer is the 13th most common cancer (2% of all new female cancer cases). In males in the UK, it is the 5th most common cancer (4% of all new male cancer cases). […] Head and neck cancer incidence rates (European age-standardised (AS) rate) for persons are significantly higher than the UK average in Scotland and Wales and Northern Ireland and significantly lower than the UK average in England. […] For head and neck cancer, like most cancer types, differences between countries largely reflect risk factor prevalence in years past. […] In the UK in 2017-2019, on average each year more than a fifth of new cases (22%) were in people aged 75 and over.

• #10 Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10304137/

  The primary risk factors commonly linked to head and neck cancer encompass tobacco, alcohol consumption, using areca nut, human papillomavirus (HPV) infection (particularly for oropharyngeal cancers), and EpsteinBarr virus (EBV) infection (especially prevalent in Asia, particularly for nasopharyngeal cancers). […] Tobacco use remains the leading risk factor for head and neck squamous cell carcinoma, accounting for an estimated 75% of all cases according to a study of cases in Western Europe. […] Alcohol consumption among nonsmokers is estimated to account for 4% of head and neck squamous cell carcinoma cases globally. […] Alcohol and tobacco have a multiplicative effect on head and neck squamous cell carcinoma. Increases in alcohol and tobacco consumption are projected to be the major contributors to growing global HNSCC incidence over the coming decades, particularly in developing nations.

• #11 Epidemiology and risk factors for head and neck cancer – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-head-and-neck-cancer

  Epidemiology and risk factors for head and neck cancer […] Head and neck cancer is common in several regions of the world. The primary risk factors associated with head and neck cancer include tobacco use, alcohol consumption, human papillomavirus (HPV) infection (for oropharyngeal cancer), and Epstein-Barr virus (EBV) infection (for nasopharyngeal cancer). The chronic exposure of the upper aerodigestive tract to these carcinogenic factors can result in dysplastic or premalignant lesions in the oropharyngeal mucosa and ultimately result in head and neck cancer. The relative prevalence of these risk factors contributes to the variations in the observed distribution of head and neck cancer in different areas of the world. […] The epidemiology of head and neck cancer and the risk factors for and pathogenesis of these tumors will be reviewed here.

• #12 Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10304137/

  HPV accounts for 72% of all head and neck squamous cell carcinoma cases in developed nations, as compared to 13% of cases in developing nations. […] HPV-positive HNSCC is now staged differently due to the large disparity in survival. […] The prevention of head and neck squamous cell carcinoma involves public health initiatives aimed at increasing oral screening and HPV vaccination, reducing exposure to tobacco, alcohol, and areca nut, and promoting a healthy lifestyle. […] HPV vaccination is currently approved as a two-dose routine vaccine beginning at ages 11-12, though it may be administered through to the age of 26 according to the US Centers for Disease Control.

• #13 Reviewing the epidemiology of head and neck cancer: definitions, trends and risk factors | British Dental Journal

  https://www.nature.com/articles/s41415-022-5166-x

  Head and neck cancer incidence is increasing and is projected to continue to rise, largely driven by increases in oropharyngeal cancer. Mortality rates have started to increase within the last decade, reflecting a rising incidence and static survival rates. Major risk factors that are associated with the risk of head and neck cancer are tobacco smoking and tobacco used in combination with alcohol consumption. Human papillomavirus is an additional major risk factor for oropharyngeal cancer. Cancers of the head and neck are clearly socioeconomically patterned but this socioeconomic risk is not entirely explained by smoking and alcohol behaviours. […] Both globally and in the UK, HNC incidence has increased over recent decades and is projected to continue to rise, largely driven by increases in oropharyngeal cancer. Mortality rates in the UK have started to increase within the last decade, reflecting rising incidence and static survival rates. In summary, the major risk factors that are associated with the risk of HNC are tobacco smoking and tobacco used in combination with alcohol consumption. Betel chewing is an established risk in Southeast Asian countries and in people from Southeast Asian minority ethnic groups. HPV is an additional major risk factor for oropharyngeal cancer. Cancers of the head and neck are clearly socioeconomically patterned, with those from the poorest backgrounds having the greatest burden, but this socioeconomic risk is not entirely explained by smoking and alcohol behaviours. Moreover, HNCs are higher among men than women (although the trends are diverging) and more common in older age-groups, although oropharyngeal cancer incidence peaks around ten years younger, at around 60-65 years.

• #14 Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37367741/

  Discrepancies in etiology as well as disparities in lifestyle choices and access to healthcare may account for the greater incidence and poorer survival of HNSCC among minority and lower-socioeconomic-status communities in developed nations. […] HPV vaccination, starting at age 11-12 for both sexes, has been shown to reduce the prevalence of high-risk HPV serologies and prevent pre-cancerous lesions of the cervix, vagina, and vulva. […] Increased adoption of vaccination, education on safe sex practices, and routine visual oral screening for high-risk patients would curb growing HNSCC incidence in developed nations.

• #15 Head and neck cancers incidence statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/head-and-neck-cancers/incidence

  Head and neck cancer incidence rates (European age-standardised (AS) rates) in England in females are 64% higher in the most deprived quintile compared with the least, and in males are 101% higher in the most deprived quintile compared with the least (2013-2017). […] It is estimated that there are around 2,300 more cases of head and neck cancer each year in England than there would be if every deprivation quintile had the same age-specific crude incidence rates as the least deprived quintile. […] An estimated 62,500 people who had been diagnosed with head and neck cancer between 1991 and 2010 were alive in the UK at the end of 2010.

• #16 Posttreatment surveillance of squamous cell carcinoma of the head and neck – UpToDate

  https://www.uptodate.com/contents/posttreatment-surveillance-of-squamous-cell-carcinoma-of-the-head-and-neck

  Posttreatment surveillance of squamous cell carcinoma of the head and neck […] Regular posttreatment follow-up is an essential part of the care of patients who are treated for squamous cell carcinoma of the head and neck. […] The goals of posttreatment surveillance are the early detection of locoregional recurrences, distant metastases, or second primary malignancies, and evaluation for and management of treatment-related complications. […] The rationale for surveillance is that early detection of either a recurrence or a second primary tumor allows for appropriate treatment and better functional and survival outcomes. […] However, controlled prospective data demonstrating a survival benefit for any follow-up strategy do not exist. […] Therefore, retrospective data and observational studies are used to guide surveillance recommendations.

• #17 Head and Neck Cancer Followup and Survivorship Clinic – Specifics | Iowa Head and Neck Protocols

  https://gme.medicine.uiowa.edu/iowaprotocols/head-and-neck-cancer-followup-and-survivorship-clinic-specifics

  The goals of surveillance for head and neck cancer (HNC) patients include early detection of locoregional recurrence, distant metastasis, or second primary malignancies, and identification and management of treatment related complications. […] Currently, no standard consensus exists on the frequency and extent of surveillance in HNC patients. […] Evidence demonstrating a clear survival benefit in HNC patients with ongoing surveillance is controversial, although some patients may benefit from early diagnosis of recurrent cancer. […] Early stage patients may show greater benefits from surveillance compared to later stage patients following definitive treatment. […] No consensus in the literature on the optimum frequency of follow-up visits after treatment with curative intent. […] Frequency of follow up can be modified for each patient depending on multiple factors including co-morbidities (breathing, swallowing, communication concerns), risk of recurrence, distances traveled, desires of informed patient.

• #18 Head and Neck Cancer Followup and Survivorship Clinic – Specifics | Iowa Head and Neck Protocols

  https://medicine.uiowa.edu/iowaprotocols/head-and-neck-cancer-followup-and-survivorship-clinic-specifics

  The goals of surveillance for head and neck cancer (HNC) patients include early detection of locoregional recurrence, distant metastasis, or second primary malignancies, and identification and management of treatment related complications. […] Currently, no standard consensus exists on the frequency and extent of surveillance in HNC patients. […] Evidence demonstrating a clear survival benefit in HNC patients with ongoing surveillance is controversial, although some patients may benefit from early diagnosis of recurrent cancer. […] Early stage patients may show greater benefits from surveillance compared to later stage patients following definitive treatment. […] No consensus in the literature on the optimum frequency of follow-up visits after treatment with curative intent. […] Frequency of follow up can be modified for each patient depending on multiple factors including co-morbidities (breathing, swallowing, communication concerns), risk of recurrence, distances traveled, desires of informed patient.

• #19 Head and Neck Cancer Followup and Survivorship Clinic – Specifics | Iowa Head and Neck Protocols

  https://gme.medicine.uiowa.edu/iowaprotocols/head-and-neck-cancer-followup-and-survivorship-clinic-specifics

  There are no universally accepted recommendations for surveillance imaging in asymptomatic patients more than 6 months after completing treatment. […] Studies show that prior neck radiation contributes to accelerated atherosclerosis and significantly greater risk for carotid artery stenosis and cerebrovascular disease. […] The NCCN Survivorship Guidelines note that carotid stenosis as a well-known late effect of radiation, but stop short of making specific screening recommendations. […] A literature review recommend ultrasound screenings for carotid artery stenosis in patients with neck radiation prior to treatment and at 1 year post treatment to optimize medical management. […] A study suggest initially screening for CAS 2 years following radiation therapy completion, then every 3 years thereafter.

• #20 Head and Neck Cancer Followup and Survivorship Clinic – Specifics | Iowa Head and Neck Protocols

  https://medicine.uiowa.edu/iowaprotocols/head-and-neck-cancer-followup-and-survivorship-clinic-specifics

  There are no universally accepted recommendations for surveillance imaging in asymptomatic patients more than 6 months after completing treatment. […] Studies show that prior neck radiation contributes to accelerated atherosclerosis and significantly greater risk for carotid artery stenosis and cerebrovascular disease. […] The NCCN Survivorship Guidelines note that carotid stenosis as a well-known late effect of radiation, but stop short of making specific screening recommendations. […] A literature review recommend ultrasound screenings for carotid artery stenosis in patients with neck radiation prior to treatment and at 1 year post treatment to optimize medical management. […] A study suggest initially screening for CAS 2 years following radiation therapy completion, then every 3 years thereafter.

• #21 Post-treatment surveillance imaging in head and neck cancer: a systematic review | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1186/s13244-023-01578-4

  This systematic review suggests that imaging may currently be underused in the post-treatment surveillance of patients with head and neck cancer. […] Analysis of 521 articles revealed that systematic imaging allowed the initial detection of locoregional recurrences and/or metastases in more than 40% of patients. […] Imaging may currently be underused in the post-treatment surveillance of patients with advanced head and neck cancer. […] Currently, there are no prospective randomized studies showing that systematic post-treatment surveillance imaging of patients with treated head and neck cancer is beneficial in terms of survival. […] Thus, this systematic review provides strong arguments in favor of systematic post-treatment imaging surveillance beyond the first post-treatment scan. […] Our data show that almost half of cases of locoregional recurrences and/or metastases were only detected by imaging (40.9%), and the mean time of detection of recurrent or metastatic disease (11.5 months) was well beyond the first post-treatment scan (36 months).

• #22 Post-treatment surveillance imaging in head and neck cancer: a systematic review | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1186/s13244-023-01578-4

  In patients treated for head and neck cancer, imaging studies are usually obtained within 36 months after treatment for assessment of treatment response. […] This systematic review focuses on the usefulness of routine (systematic) post-treatment imaging surveillance of head and neck cancer beyond the first 36-month baseline imaging study. […] Analysis of these records showed that almost half of cases of locoregional recurrences and/or metastases were only detected by imaging (40.9%), and the mean time of detection of recurrent or metastatic disease (11.5 months) was well beyond the period of the first post-treatment scan. […] Strong arguments were found in favor of systematic imaging surveillance in locoregional advanced head and neck cancer during at least one and preferably 2 years after treatment.

• #23 Surveillance Education – American Head & Neck Society

  https://www.ahns.info/survivorship_intro/surveillance-education/

  Head and neck cancer patients should have thyroid hormone testing every 6-12 months if they have received radiation. Sometimes EBV bloodwork is recommended if you have nasopharyngeal cancer. […] When should surveillance Imaging Be performed After Treatment for head and neck cancer? […] The impact of Compliance in Posttreatment Surveillance in head and Neck Squamous Cell carcinoma. […] Head Neck.

• #24 Head and Neck Cancer Followup and Survivorship Clinic – Specifics | Iowa Head and Neck Protocols

  https://gme.medicine.uiowa.edu/iowaprotocols/head-and-neck-cancer-followup-and-survivorship-clinic-specifics

  Recommend checking thyroid-stimulating hormone (TSH) every 6-12 months if neck irradiated. […] Annual screening for panhypopituitarism following radiation to the skull base. […] Recommend thyroglobulin with thyroglobulin antibodies for well differentiated thyroid cancer every 6 to 12 months. […] Dysphagia can be a long term problem for head and neck cancer patients. Monitor patients for swallowing related problems during each follow up visit and provide referrals. […] Consider ongoing surveillance for depression.

• #25 Head and Neck Cancer Followup and Survivorship Clinic – Specifics | Iowa Head and Neck Protocols

  https://medicine.uiowa.edu/iowaprotocols/head-and-neck-cancer-followup-and-survivorship-clinic-specifics

  Recommend checking thyroid-stimulating hormone (TSH) every 6-12 months if neck irradiated. […] Annual screening for panhypopituitarism following radiation to the skull base. […] Recommend thyroglobulin with thyroglobulin antibodies for well differentiated thyroid cancer every 6 to 12 months. […] ctDNA in patients with HPV+ oropharyngeal squamous cell carcinoma has emerged as a diagnostic tool to detect the presence of recurrent cancer. […] A large retrospective study demonstrated 95% positive and negative predicted values for recurrent cancer when evaluating circulating TTMV-HPV DNA at least 3 months after definitive treatment. […] Prospective studies are under way to help clarify how to incorporate HPV ctDNA testing during surveillance. […] The significance of non-viral ctDNA, ctDNA gene methylation, and exosomes are areas of on-going investigation. […] Dysphagia can be a long term problem for head and neck cancer patients. Monitor patients for swallowing related problems during each follow up visit and provide referrals. […] Consider ongoing surveillance for depression.

• #26 Head and neck cancer surveillance: A guide past the five-year mark

  https://www1.racgp.org.au/ajgp/2024/supplement-december/head-and-neck-cancer-surveillance

  Following a patients discharge from tertiary care, we recommend an annual clinic appointment dedicated to their head and neck cancer surveillance with GP specialists to follow up on any functional sequelae from treatment and to exclude recurrent or second malignancies. […] Risk stratifying and effective counselling have vital roles within head and neck cancer surveillance. Smoking and alcohol are the leading risk factors for head and neck cancer (in particular those not caused by human papillomavirus [HPV]), and patients who continue to partake are at exceptionally high risk of developing recurrence or a second primary malignancy. Cessation of tobacco smoking and alcohol consumption is of vital importance and has been shown to reduce head and neck cancer patients risk of further cancer. […] A second primary malignancy contributes to a 23% mortality rate in head and neck cancer survivors. The lung is the most common location for developing a second primary malignancy in HNSCC survivors. Following diagnosis of a second lung malignancy, survival is exceptionally poor.

• #27 Head and neck cancer surveillance: A guide past the five-year mark

  https://www1.racgp.org.au/ajgp/2024/supplement-december/head-and-neck-cancer-surveillance

  Updated guidelines from the National Comprehensive Cancer Network recommend that patients with head and neck cancer with a 20 pack-year or more smoking history undertake annual screening with low-dose computed tomography (LDCT). […] In conclusion, the management and surveillance of head and neck cancer survivors represent a critical aspect of these patients ongoing care. As the incidence of HNSCC continues to rise globally, it is essential for healthcare providers, especially GPs, to be well equipped to face the challenges and responsibilities associated with surveillance past the five-year mark. Through a structured annual surveillance appointment, the key elements to the long-term care for the head and neck cancer survivor include risk stratification, counselling for lifestyle changes, detecting recurrence/second primary malignancies, managing chronic symptoms and providing essential psychosocial support. A multidisciplinary approach, close attention to red flag symptoms and collaboration with specialists when necessary are crucial to providing holistic and comprehensive care for the head and neck cancer survivor.

• #28

  https://journals.lww.com/co-oncology/fulltext/2020/05000/epidemiology_of_head_and_neck_cancers__an_update.3.aspx

  To decrease HNC incidence, measures to reduce tobacco use and alcohol consumption remain essential. Improvement of HPV vaccination coverage is also a major objective. Reduction of carcinogens at occupation, protection of workers from carcinogen exposures, education for better diet, and easy and affordable access to fruits and vegetables can contribute to incidence decrease.

• #29 Head and Neck Cancer in Patients with Fanconi Anemia – Fanconi Cancer Foundation

  https://fanconi.org/clinical-care-guidelines/head-and-neck-cancer-in-patients-with-fanconi-anemia/

  Head and neck squamous cell carcinoma (HNSCC) is significantly more common in patients with Fanconi anemia (FA) than in the general population. This chapter provides an overview of HNSCC in patients with FA. Focus areas include early surveillance, risk factors, diagnosis, and currently available treatment options. Head and neck cancers are diagnosed at a younger age (20-50 years) in patients with FA and often at an advanced stage. The cornerstone treatment for FA patients with HNSCC is surgery; however, outcomes are poor if the diagnosis is at an advanced stage. Patients with FA also have significant toxicity issues from systemic chemotherapies used to treat HNSCC in the general population. The precise risk factors associated with HNSCC for patients with FA have yet to be defined, although studies have shown that DNA repair defects associated with the disease, increased age, and graft-versus-host disease (GvHD) after hematopoietic cell transplant (HCT) correlate with increased risk for HNSCC development. Causative well-defined risk factors in the general population, such as tobacco and alcohol use, should be avoided by patients with FA. It is recommended that early surveillance by oral examination begin at a young age.

• #30 Head and Neck Cancer in Patients with Fanconi Anemia – Fanconi Cancer Foundation

  https://fanconi.org/clinical-care-guidelines/head-and-neck-cancer-in-patients-with-fanconi-anemia/

  The high incidence of HNSCC combined with the poor outcome of this disease in patients with FA underscore the need for careful HNSCC surveillance. Surveillance should begin at age 10, which is based on literature reports of the earliest age of HNSCC diagnosis. The oral cavities of individuals with FA often contain multiple lesions. Distinguishing suspicious lesions from those that are non-cancerous requires the input of a health care provider with significant experience in the evaluation and management of HNSCC for FA patients. […] Patients with FA have an increased risk for developing aggressive head and neck squamous cell carcinoma (HNSCC), especially of the oral cavity. Until new therapeutic and preventative measures are available, strict abstinence from tobacco and alcohol, avoidance of second-hand smoke, maintenance of oral hygiene, and aggressive routine screening are the most immediate ways to reduce the development and morbidity of HNSCC in FA patients. Early and frequent head and neck examinations, including careful oral cavity evaluations and flexible fiberoptic laryngoscopy, are important surveillance measures. Appropriate surgical resection remains the mainstay of treatment for patients with FA, because radiation and chemotherapy are poorly tolerated. If radiation and chemotherapy are required for advanced tumors, they should be used with caution and by physicians who have experience in identifying, preventing, and treating associated complications.

• #31 Clinical impact of surveillance for head and neck cancer in patients with esophageal squamous cell carcinoma

  https://www.wjgnet.com/1007-9327/full/v23/i6/1051.htm

  AIM: To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC). […] Surveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC. […] Most of patients with esophageal squamous cell carcinoma (ESCC) have a high prevalence of second primary head and neck squamous cell carcinoma (HNSCC). […] The innovation of narrow-band imaging (NBI) has allowed for the early diagnosis of head and neck cancer. […] In conclusion, endoscopic surveillance using NBI for the HN region improved detection of both synchronous and metachronous superficial HNSCC in patients with ESCC. The early detection and intervention for HNSCC might lead to the reduction of serious adverse events and the risk of death related to HNSCC.

• #32 PET-CT-guided, symptom-based, patient-initiated surveillance versus clinical follow-up in head neck cancer patients (PETNECK2): study protocol for a multicentre feasibility study and non-inferiority, randomised, phase III trial | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12470-9

  PETNECK2 will examine the effectiveness of PET-CT imaging – introduced at one year after completion of treatment to determine patients at low risk of recurrence. We hypothesise that this PET-CT scan may identify some patients with asymptomatic recurrence (allowing earlier intervention with salvage therapies), but also those at very low risk of future recurrence.

• #33 PET-CT-guided, symptom-based, patient-initiated surveillance versus clinical follow-up in head neck cancer patients (PETNECK2): study protocol for a multicentre feasibility study and non-inferiority, randomised, phase III trial | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12470-9

  Approximately 40% of treated head and neck cancer (HNC) patients develop recurrence. The risk of recurrence declines with time from treatment. Current guidelines recommend clinical follow-up every two months for the first two years after treatment, with reducing intensity over the next three years. However, evidence for the effectiveness of these regimes in detecting recurrence is lacking, with calls for more flexible, patient-centred follow-up strategies. […] Despite being the international standard, current strategies for HNC surveillance lack a robust evidence base for their effectiveness or efficiency and are inflexible. The rate of cancer recurrence detection in asymptomatic patients through routine clinical surveillance is low, with published data suggesting only between 27 and 51% of patients with recurrence can be offered salvage treatment.

• #34 PET-CT-guided, symptom-based, patient-initiated surveillance versus clinical follow-up in head neck cancer patients (PETNECK2): study protocol for a multicentre feasibility study and non-inferiority, randomised, phase III trial | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12470-9

  This fear of cancer recurrence (FCR) has a major impact on patients overall quality of life and is well documented in HNC patients, yet no studies have examined the effect of different follow-up regimens on FCR. […] This programme of work included development of a bespoke IS resource package and an initial feasibility study to optimise the education session and IS resource package given prior to the phase III Randomised Controlled Trial (RCT), which will formally assess the efficacy and cost-effectiveness of this patient-initiated active surveillance strategy compared to the current standard of care routine scheduled clinical follow-up. […] We hypothesise that combining an additional 12-month post-treatment PET-CT scan and IS resource will both identify patients with asymptomatic recurrence and identify those at low risk of future recurrence who will be empowered to monitor their symptoms and seek early clinical follow-up when recurrence is suspected. This change to a patient-centred model of care may have effects on both quality of life and fear of cancer recurrence.

• #35 Surviving cancer, but still suffering – Northwestern Now

  https://news.northwestern.edu/stories/2025/04/surviving-cancer-still-suffering-survey-reveals-gaps-in-followup-care/

  A new Northwestern Medicine study found most head-and-neck cancer survivors who underwent radiation dont know about survivorship care, even as many grapple with side effects such as lingering dry mouth, swallowing problems and psychological distress. […] Standard followups typically focus on cancer surveillance, yet longerliving survivors may also increasingly need chronic disease management, preventive care and psychosocial support. […] More than 70% said mental health concerns were not addressed during treatment and only 28% had access to information on how to access survivorship care. […] But throughout the U.S., comprehensive survivorship is rarely offered or even discussed. […] These programs, Gharzai said, should be grounded in the Cancer Survivorship Framework, a novel approach that addresses five key areas: physical effects, psychosocial health, cancer screening, chronic disease management and health promotion.

• #36 Surviving cancer, but still suffering – Northwestern Now

  https://news.northwestern.edu/stories/2025/04/surviving-cancer-still-suffering-survey-reveals-gaps-in-followup-care/

  The findings underscore a pressing need as the survivor population keeps growing. In 2022, there were 18.1 million cancer survivors in the U.S. about 5.4 percent of the population, according to the Journal of the National Cancer Institute. Advances in detection and treatment, and an aging population, are expected to push that number to 26 million by 2040. […] Gharzais team is turning the studys insights into action. They are building a personalized survivorship clinic inside Northwestern Memorial Hospitals Department of Radiation Oncology, starting with head-and-neck cancer, structured around all five domains of the Cancer Survivorship Framework.

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