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      The burden of head and neck cancer in Africa: the status quo and research prospects

      research-article
      , ,
      South African Dental Journal
      The South African Dental Association (SADA)
      Oral cancer burden, Africa, research, HNC, UADTC

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          Abstract

          BACKGROUND: The increasing incidence of head and neck cancer (HNC) in Africa is mostly due to increasing smoking habits, westernization in lifestyle and diet, HIV/HPV and unfavourable fiscal policies for health Oral cancer potentially constitutes a notable fraction of the global cancer burden, particularly in developing Africa. A heterogeneity in the anatomy-based HNC nomenclature has resulted in underestimation of its incidence and significance worldwide. METHOD: The global cancer statistics database (GLOBOCAN) was used to evaluate the combined data of cancer incidence in two subsets: a.) excluding HNC and b.) including oesophageal cancers (Upper Aerodigestive Tract Cancer: UADTC). Combined age standardized incidence rates (ASIR) of HNC and UADTC were analyzed using both regional and individual country-derived data RESULT: Frequency ranking of HNC in Africa increases dramatically when cancers from contiguous HN regions are evaluated, compared with considering oral cancer data alone UADTC and HNC ranked second and third in Africa, respectively. Similar trends were observed by global development index evaluation. CONCLUSION: With the exclusion of a few urban regions, the diagnostic and treatment opportunities for HN/UADT cancers in sub-Saharan Africa are dismal Effective education and research efforts by local and international (non-) governmental agencies are urgently required to reduce the associated morbidities.

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          Most cited references34

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          Expansion of cancer care and control in countries of low and middle income: a call to action.

          Substantial inequalities exist in cancer survival rates across countries. In addition to prevention of new cancers by reduction of risk factors, strategies are needed to close the gap between developed and developing countries in cancer survival and the effects of the disease on human suffering. We challenge the public health community's assumption that cancers will remain untreated in poor countries, and note the analogy to similarly unfounded arguments from more than a decade ago against provision of HIV treatment. In resource-constrained countries without specialised services, experience has shown that much can be done to prevent and treat cancer by deployment of primary and secondary caregivers, use of off-patent drugs, and application of regional and global mechanisms for financing and procurement. Furthermore, several middle-income countries have included cancer treatment in national health insurance coverage with a focus on people living in poverty. These strategies can reduce costs, increase access to health services, and strengthen health systems to meet the challenge of cancer and other diseases. In 2009, we formed the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, which is composed of leaders from the global health and cancer care communities, and is dedicated to proposal, implementation, and evaluation of strategies to advance this agenda. Copyright © 2010 Elsevier Ltd. All rights reserved.
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            Global cancer statistics

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              Interleukin 6 and interleukin 8 as potential biomarkers for oral cavity and oropharyngeal squamous cell carcinoma.

              Since morbidity and mortality rates due to oral cavity and oropharyngeal squamous cell carcinoma (OSCC) have improved little in the past 30 years, early detection or prevention of this disease is likely to be most effective. Using laser-capture microdissection, we have identified the expression of 2 cellular genes that are uniquely associated with OSCC: interleukin (IL) 6 and IL-8. These cytokines may contribute to the pathogenesis of this disease, and have been linked with increased tumor growth and metastasis. To investigate whether IL-6 and/or IL-8 could serve as informative biomarkers for OSCC in saliva and/or serum and to determine if there is a role for saliva as a diagnostic medium for OSCC. Patients with newly diagnosed T1 or T2 oral cavity or oropharyngeal histologically confirmed squamous cell carcinoma were recruited for the study. Age and sex-matched disease-free subjects were used as controls. Using quantitative real-time polymerase chain reaction analysis and enzyme-linked immunosorbent assay, we respectively assessed the expression of IL-6 and IL-8 in serum (controls, n = 32; patients with OSCC, n = 19) and saliva (controls, n = 32; patients with OSCC, n = 32) at the messenger RNA (mRNA) and protein levels. Specificity and sensitivity of these biomarkers for OSCC and their predictive value. Interleukin 8 was detected at higher concentrations in saliva (P .75). Using statistical analysis, we were able to determine the threshold value, sensitivity, and specificity of each biomarker, as well as a combination of biomarkers, for detecting OSCC. Our findings indicate that IL-8 in saliva and IL-6 in serum hold promise as biomarkers for OSCC. A saliva-based test could be a cost-effective adjunctive tool in the diagnosis and follow-up of patients with OSCC.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                sadj
                South African Dental Journal
                S. Afr. dent. j.
                The South African Dental Association (SADA) (Johannesburg, Gauteng, South Africa )
                0011-8516
                0375-1562
                September 2018
                : 73
                : 8
                : 477-488
                Affiliations
                [01] Cape Town orgnameUniversity of the Western Cape at Tygerberg Hospital orgdiv1Faculty of Dentistry orgdiv2Department of Oral and Maxillofacial Pathology South Africa
                [02] Cape Town orgnameUniversity of Cape Town orgdiv1Faculty of Health Sciences and Groote Schuur Hospital orgdiv2Department of Medicine South Africa
                [03] Tygerberg orgnameNational Health Laboratory Service South Africa
                Article
                S0011-85162018000800003
                10.17159/2519-0105/2018/v73no8a1
                baea833b-fe5e-4acf-b95e-29a0748d233a

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 49, Pages: 12
                Product

                SciELO South Africa

                Categories
                Research

                research,Oral cancer burden,Africa,HNC,UADTC
                research, Oral cancer burden, Africa, HNC, UADTC

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