A demographic review of stage of presentation and survival rates of head and neck cancer patients in the Western Cape, South Africa

Master Thesis


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Most literature reports significantly poorer access to healthcare, more advanced cancers, and worse survival in rural and remote populations. This study investigates if significant disparities exist with regard to stage at presentation and overall survival of patients with head and neck cancer (HNC) between geographical areas within the Western Cape Province in South Africa. A retrospective chart review was conducted on all patients managed with both curative and palliative intent through the Combined ENT/Head and Neck Oncology clinic at Groote Schuur Hospital in the five-year period from January 2010 to December 2014. Ethics approval was granted by the University of Cape Town Human Research Ethics Committee (HREC, 351-2017). Although we observed no significant difference in TNM clinical stages or overall survival between metropolitan and remote patients, there were statistically and clinically significant differences in terms of both stages of HNC and survival between some individual metropolitan and remote areas. The remote area of Eden had a median overall survival of more than 6 months less than that of the Southern subdistrict of the City of Cape Town. These discrepancies in HNC stages and survival are likely multifactorial, involving socioeconomic and demographic factors in addition to geographic factors.