Asian Pacifc Journal of Cancer Prevention, Vol 15, 2014 537 DOI:http://dx.doi.org/10.7314/APJCP.2014.15.2.537 Head and Neck Cancer in India: Global and Regional Trends Asian Pac J Cancer Prev, 15 (2), 537-550 Cancer in India: Global Perspective The total burden of cancer across the globe is estimated to be around 22 million (WHO-UICC 2003). Approximately 10 million new cases of cancer are diagnosed every year across the globe (WHO-UICC 2003). The cancer incidence of the world in terms of income as per the world bank data is briefy depicted in Table 1. It is evident that more than 5 billion people (85% of the world’s population) reside in developing countries that account for only 20% of the global gross national product2. Hence the great majority of new cases (more than 60%) are from the developing world including India. Cancers in all forms are causing about 12% deaths throughout the world (WHO- UICC 2003). In developed country cancer is the second leading cause of death accounting for 21% (2.5 million) of all mortality. In developing countries cancer ranks third as a cause of death and accounts for 9.5 % (3.8 million) of all deaths (NCCP 2006). It is estimated that by the end of the year 2020 over 10 million people world wide would die of cancer every year (WHO-UICC 2003) and that 66% of these would be from the newly industrialized and the developing world (WHO 2003). WHO has categorically stated that in 2020, regions with traditionally low numbers of cancer deaths could see alarming increases in the mortality rates (WHO 2003). Regions including northern Africa, western Asia, south America, the Caribbean and south east Asia would face sharp increases of over 75% in 1 Department of Otolaryngology and Head and Neck KG Medical University Lucknow, 2 Rama Medical College, Mandhana Kanpur, India *For correspondence: amishra_ent@yahoo.com Abstract The actual burden of head and neck cancer in India is much greater than refected through the existing literature and hence can be regarded as a ‘tip of iceberg’ situation. This has further been evident by the recent reports of ‘Net-based Atlas of Cancer in India’. South-east Asia is likely to face sharp increases of over 75% in the number of cancer deaths in 2020 as compared to 2000. Since the percentage increase of Indian population has been nearly twice that of the world in last 15 years there is a likelihood of increase in cancer burden with the same proportion. The distribution of population based cancer registries is grossly uneven with certain important parts of the country being not represented at all and hence the current cancer burden is not refected by registry data. However, the pathetic situation of health care system in major parts of the country as also emphasized by the World Bank, is not suitable to provide anywhere near accurate data on cancer burden. Head and neck cancer (including thyroid lesions) is third most common malignancy seen in both the sexes across the globe but is the commonest malignancy encountered in Indian males. Also oral cavity cancer is the most prevalent type amongst the males and one of the highest across the globe. This article reviews the latest global and national situation with an especial emphasis on head and neck cancer. Furthermore this review focuses on burden in different sub sites at national and global levels. Keywords: Cancer - lip - tongue - oral cavity - oropharynx - nasopharynx - hypopharynx - larynx - thyroid - India REVIEW Head and Neck Cancer: Global Burden and Regional Trends in India Anupam Mishra 1 *, Rohit Meherotra 2 the number of cancer deaths in 2020 as compared to 2000. India being a major contributor to population explosion is likely to run a great risk of producing cancer burden. Table 2 depicts that within last 15 years the percentage increase of Indian population is twice that of the world and has supposedly contributed to maximum population growth across the lower or the middle income countries. Cancer pattern varies not only through out the world but also between different populations groups within the same country. In general the more common cancers in males across the globe in order of prevalence are that of the lung and prostrate while those in females are that of breast and uterus. Therefore the cancer of head and neck (including thyroid) follows next as the third common malignancy seen in both the sexes across the globe. As mentioned before the majority of the total world population resides in the developing countries especially Table 1. Relative Economies of the Countries Economies* Total No. Countries with available of countries* data on cancer incidence NO. Percentage of total Low income 61 15 24.59 Lower middle income 56 19 33.92 Upper middle income 37 14 37.83 High income 54 28 51.85 *Data and Statistics of the World Bank Group