Late-stage diagnosis for head and neck cancers rise in Northern Ireland

‘Too many cases of head and neck cancers are being diagnosed at a late stage in Northern Ireland, resulting in poorer prognosis and higher mortality’ – this is according to Cancer Focus NI and the British Dental Association.

As Mouth Cancer Action Month kicks off in November, both organisations are calling for full implementation of the Northern Ireland Cancer Strategy.

Newly-collected data shows:

• Late-stage tumours (T3/T4) increased from 33.76% of 470 cases in 2019 to 41.47% of 371 cases in 2020
• The number of referrals in 2020 reduced by 22.1%. This points to the significant impact Covid-19 has had on head and neck cancer presentation here.

More specifically, they are urging for commitment to raising public awareness of the risk factors, early signs of mouth cancer and the importance of regular dental check-ups for at risk patients.

In addition, the number of people diagnosed with oral cancer in Northern Ireland has increased by more than 80% between 1993 and 2018. The relative spike is greater among women than men.

Significant impact

Professor Gerry McKenna, chair of BDA NI Hospitals Group said: ‘The data confirms the significant impact the Covid-19 pandemic has had on reduced head and neck cancer detection and referrals.

‘Later-stage diagnosis in the wake of what has been traditionally a less than optimal picture by way of detection and diagnosis.

‘It’s important we put this into context. A large proportion of our head and neck cancer patients are not patients who are struggling to attend their general dental practice. They are people who do not (and have never) engaged with health services generally, hence the history of late presentation.’

The BDA and Cancer Focus NI state that early detection is key. However they warn that the situation could get worse before it improves.

Dervilia Kernaghan is director of services at Cancer Focus NI. She said: ‘Cancer Focus NI’s health improvement services emphasise the importance of checking for signs and symptoms of cancer.

‘If mouth cancer is spotted early, the chances of a complete cure are greatly increased. When cancerous lesions are small, treatment is generally less complicated and more effective.

‘It’s vitally important that you go to your dentist or GP if you notice any worrying symptoms as soon as possible, which can include pain in the mouth or earache that persists, a lump in the neck, or difficulty or pain with chewing, swallowing, or speaking.’

Urgent solutions needed

Dervilia added: ‘The Cancer Strategy identifies attendance for routine examination and care as an ideal time for ‘opportunistic’ screening.

‘With cancer incidence rates much greater in areas of high deprivation, all our population needs access to vital dental services. Later this month, our charity will host up to 100 patients and carers at our head and neck cancer support and information cay.

‘A common theme from this event will be the need for fewer barriers in the way to detection, referral, and diagnosis. Now more than ever, we call on our local government to find urgent solutions to a very immediate threat in Northern Ireland.’