An open letter to primary healthcare services
Early detection of head and neck cancer will improve patient outcomes.
We, from Head & Neck Cancer Support Aotearoa and the Head and Neck Cancer Foundation Aotearoa, hope to raise awareness of head and neck cancer among primary health providers.
Key messages:
Head and neck cancers are on the rise, and Māori have lower survival rates.
HPV has overtaken tobacco and alcohol as the main cause of oropharyngeal cancer (OPC).
Early detection leads to much better outcomes.
Patients with symptoms or signs* of head and neck cancer should be referred promptly to the regional head and neck cancer service.
Primary care has a vital role to play in early detection – remember to look inside the mouth when examining patients!
Gardasil is crucial in preventing OPC – consider recalling all your unvaccinated young people before they turn 27.
Background:
Head and neck cancer is the sixth most common cancer globally. In Aotearoa New Zealand, over 1500 people are diagnosed with head and neck cancer each year. Cases of head and neck cancer are on the rise in Aotearoa, particularly OPC, which has been rising by five percent every year since 2006 (Win Myint T.T. et al, 2023).
HPV has overtaken tobacco and alcohol as the main cause of OPC. HPV-related OPC typically affects younger individuals. Māori are also disproportionately affected by OPC, with lower survival rates (Win Myint T.T. et al, 2023).
Head and neck cancer patients face invasive treatments that can result in functional loss such as inability to taste, eat and speak, and deformity of the face, leading to loss of quality of life. Diagnosis of head and neck cancer is challenging because of the lack of awareness and the myriad of signs and symptoms. Greater awareness of the symptoms and signs of head and neck cancer in primary care including oral health, could significantly improve patient outcomes through early diagnosis and treatment.
Primary care also plays a key role in the promotion of head and neck cancer prevention. This includes discussing HPV immunisation with patients and caregivers, for those under aged 27 years, and signposting to culturally-appropriate smoking cessation support.
*Symptoms or signs that might indicate head and neck cancer, if they persist for more than 3 weeks:
A painless lump in the neck or in front of the ear.
A lump or ulcer in the mouth (such as the tongue, gum, palate or the inside the cheek) and throat.
A persistent white or red patch in the mouth.
One-sided sore throat which can be associated with earache.
Pain or difficulty with swallowing.
Hoarse voice, especially in a smoker.
Difficult or noisy breathing.
A lump or sore on the face.
Numbness or weakness on one side of the face.
One-sided blocked nose with bleeding.
Patient resources:
Awareness poster for waiting rooms and bathrooms - view + download here
Information leaflets on HPV, vaccination and throat cancer: stief.org.nz/resources/patient-leaflets.
General leaflet on head and neck cancer from the Cancer Society.
HNCSA provides support for head and neck cancer patients and their whānau.
Thank you to The Swallows UK for giving us permission to use and adapt their awareness posters.
