Head and neck cancer in the UK: what was the stage before COVID-19? UK cancer registries analysis (2011-2018). Br Dent J 2022; https://doi.org/10.1038/s41415-022-5151-4

figure 1

Why did you decide to undertake this study?

With all cancers, the earlier the disease is detected, the better chance you have of a more positive outcome and fewer long-term morbidities. This is especially true for head and neck cancer (HNC). The evidence suggests that a later stage/more advanced disease at diagnosis is a significant factor in poor prognosis. For some cancer groups, the national incidence of new cancers by stage at diagnosis is widely known and routinely reported. This isn't the case for HNCs where our understanding of late-stage diagnosis comes from audits/cohort studies. In order to reduce the burden of late-stage disease, we thought it important to utilise any data held at the National Cancer Registries so that we can accurately understand and address this public health issue. This will also help us to evaluate in the near future the effect of the COVID-19 pandemic on our HNC system.

Did any of the results surprise you?

The existing evidence had stated that Stage III and IV HNCs were the slight majority for most HNC subgroups; however, it was disappointing to see that when analysing those cases where stage at diagnosis is recorded at the national registry level, the proportion of people being diagnosed with later disease is higher than previously stated or estimated in past studies - as high as two-thirds in Scotland, Wales and Northern Ireland and still the significant majority in England. It was interesting that stage at diagnosis of HNCs is still not recorded for 100% of cases in the registry but is becoming more complete.

What do you think the next steps should be considering your findings?

Identifying and understanding the various factors associated with advanced HNCs is crucial if we want to have any chance in improving early detection rates. This is something that the EU Horizon 2020 Funded HEADSpAcE Consortium is researching across Europe and South America through multiple studies, including my own PhD research. Thanks for reading!