Late presentation of laryngeal and nasopharyngeal cancer in Kenyatta National Hospital.

The clinical stage at presentation of laryngeal and pharyngeal cancer is an important determinant of survival. Fifty six patients admitted at Kenyatta National Hospital with nasopharyngeal and laryngeal carcinoma were reviewed to determine the period of delay from onset of illness to the first otolaryngologic appointment at the hospital, their clinical features and the tumour stage at presentation. All cases of nasopharyngeal carcinoma had cervical lymphadenopathy, 70.6% being N3 status while 57.8% of laryngeal carcinoma cases underwent emergency preoperative tracheostomy due to bulky obstructive tumour. On the whole, 96.4% of the patients presented with advanced (stage 3 or 4) head and neck carcinomas. The average period of delay between the first medical attention at a primary health care facility and the first appointment at the national hospital was 8.7 months. The study suggests that this long delay was due to inherent inefficiency in the referral system and was a major contributing factor to the advanced stage at presentation.