Honnet Simon M, Edkins Oskar, Dalvie Sameera, Wetter Julie A, Harvey Justin, Fagan Johannes J
Department of Surgery, Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Department of Otolaryngology, Head and Neck Surgery, Townsville University Hospital, Townsville, Australia.
J Coll Med S Afr. 2024 Mar 15;2(1):2. doi: 10.4102/jcmsa.v2i1.2. eCollection 2024.
The Western Cape province in South Africa has a high age-standardised mortality from cancer. Most literature reports significantly poorer access to healthcare, more advanced cancers and worse survival for 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 at the Combined ENT & Head and Neck Oncology clinic at Groote Schuur 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 overall 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.
Differences in HNC stages and overall survivals between some subdistricts of the City of Cape Town and remote areas are not only statistically significant but also clinically relevant.
This article highlights the need to improve on diagnostic and referral pathways for management of patients with HNC in the Western Cape.
南非西开普省癌症的年龄标准化死亡率很高。大多数文献报告称，农村和偏远地区人群获得医疗保健的机会明显更少，癌症病情更严重，生存率更低。本研究调查了南非西开普省内不同地理区域的头颈癌（HNC）患者在就诊时的分期和总生存率方面是否存在显著差异。
对2010年1月至2014年12月在格罗特舒尔综合耳鼻喉科与头颈肿瘤诊所接受治疗的所有患者进行回顾性病历审查。该研究获得了开普敦大学人类研究伦理委员会（HREC，351 - 2017）的伦理批准。
尽管我们观察到大城市地区和偏远地区患者在TNM临床分期或总生存率方面没有显著差异，但在一些个别大城市地区和偏远地区之间，头颈癌分期和总生存率在统计学和临床上均存在显著差异。伊登偏远地区的总生存期中位数比开普敦市南区少6个月以上。
开普敦市一些分区与偏远地区之间在头颈癌分期和总生存率方面的差异不仅在统计学上具有显著性，而且在临床上也具有相关性。
本文强调了改善西开普省头颈癌患者诊断和转诊途径的必要性。
