Feature Article

Head and neck cancer: a guide to diagnosis and an overview of management

Ron Bova



Head and neck cancers account for about 3 to 4% of all malignancies. This article focuses on mucosal squamous cell carcinoma, which is the most common type to affect this region of the body.

Key Points

  • The major risk factors for SCC of the head and neck are tobacco and alcohol use. The incidence would almost certainly decline significantly if smoking and excessive drinking were eliminated.
  • It is important to remember that the majority of persistent neck lumps occuring in adults are malignant.
  • Between 1 and 3% of patients who present with a head and neck cancer have another primary tumour somewhere in their upper aerodigestive tract. Therefore, a thorough and comprehensive evaluation is warranted.
  • Fine needle aspiration cytology has an accuracy of approximately 95% for diagnosing SCC. Incisional biopsy of a neck node is contraindicated because it may compromise the success of future therapies.
  • Treatment of head and neck tumours is often complex. Careful consideration of multiple factors is required to optimise the chance of cure while minimising patient morbidity.
  • The majority of head and neck cancers are potentially treatable. However, patients sometimes have severe medical comorbidities or very advanced stage disease which precludes curative treatment.