Epidemiology and Histopathological Spectrum of Head and Neck Cancers in Bihar, a State of Eastern India

Head and neck cancers are amongst the commonest malignancies, accounting for approximately 20% of thecancer burden in India. The major risk factors are tobacco chewing, smoking and alcohol consumption, whichare all preventable. This retrospective study presents data from the histopathology register for a five year periodfrom 2002-2006 at Patna Medical College and Hospital, a tertiary care hospital drawing patients from the entireBihar state, the 3rd most populous state of India with the majority of the population residing in rural areas.Incidence rates based on sex, age, site of lesion, including age standardized incidence rates for males and females,with mean age of presentation, distribution of histological variants and year wise trend were calculated. Out of455 head and neck neoplasias, 241 were benign while 214 were malignant. The most common age group for allmalignant biopsies was 7th decade for males and the 5th decade for females. Malignant cases were commonerin males than females with the male:female ratio of 3.1:1, which was found to be statistically significant by thechi-square (χ2) test. The crude rate and age standardized incidence rate was 0.05 and 0.06 per 100,000 populationrespectively. Squamous cell carcinoma (SCC) contributed about 96% of all cases, with grade I being the mostcommon. Larynx was the most common site for malignancy, the supraglottic region being its most commonlyaffected sub-site. This observed incidence patterns in the region are a reminder of widespread unawareness,low healthcare utilization with virtually non-existent cancer programs. It also underlines the need to advocatefor reliable cost-effective programs to create awareness, for early detection and plan appropriate managementstrategies. There is a compelling demand for a cancer registry in this region as well as proper implementationof preventive measures to combat this growing threat of cancer, many of whose risk factors are preventable.