Is AJCC/UICC Staging Still Appropriate for Head and Neck Cancers in Developing Countries?

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Is AJCC/UICC Staging Still Appropriate for Head and Neck Cancers in Developing Countries?

JournalOTO Open
Publication date – Jul – 2020
Authors – Johannes J Fagan, Julie Wetter, Jeffrey Otiti , Joyce Aswani , Anna Konney , Evelyne Diom , Kenneth Baidoo, Paul Onakoya , Rajab Mugabo , Patrick Noah , Victor Mashamba , Innocent Kundiona , Chege Macharia , Mohammed Garba Mainasara , Melesse Gebeyehu , Mesele Bogale , Khaled Twier , Marco Faniriko , Getachew Beza Melesse , Mark G Shrime
KeywordsUICC/AJCC; cancer; developing countries; head and neck; oropharyngeal; p16; staging
Open access – Yes
SpecialityENT surgery, Surgical oncology
World region Central Africa, Eastern Africa, Middle Africa, Northern Africa, Southern Africa, Western Africa

Language – English
Submitted to the One Surgery Index on July 26, 2020 at 7:32 am
Abstract:

By 2030, 70% of cancers will occur in developing countries. Head and neck cancers are primarily a developing world disease. While anatomical location and the extent of cancers are central to defining prognosis and staging, the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) have incorporated nonanatomic factors that correlate with prognosis into staging (eg, p16 status of oropharyngeal cancers). However, 16 of 17 head and neck surgeons from 13 African countries cannot routinely test for p16 status and hence can no longer apply AJCC/UICC staging to oropharyngeal cancer. While the AJCC/UICC should continue to refine staging that best reflects treatment outcomes and prognosis by incorporating new nonanatomical factors, they should also retain and refine anatomically based staging to serve the needs of clinicians and their patients in resource-constrained settings. Not to do so would diminish their global relevance and in so doing also disadvantage most of the world’s cancer patients.

OSI Number – 20599
PMID – 32671318

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