International Research Journal of Oncology

Background: Head and Neck Squamous Cell Carcinoma (HNSCC) accounts for a substantial proportion of cancer cases globally and represents a significant contributor to cancer-related morbidity and mortality, particularly in India. The global incidence of HNSCC is steadily increasing, with an estimated 900,000 new cases and approximately 400,000 deaths reported annually. Currently, HNSCC ranks as the sixth most common cancer worldwide, and projections indicate a 30% rise in incidence by 2030. We in our institute conducted a cross-sectional study to systematically examine and describe the demographic characteristics and associated risk factors of patients diagnosed with head and neck squamous cell carcinoma (HNSCC) in North Indian population.

Aim: To evaluate the epidemiological profile of patients diagnosed with Head and Neck Squamous Cell Carcinoma (HNSCC) in North India by analysing demographic patterns, risk factor exposure, clinical presentation, and site-specific distribution of the disease.

Study Design:  A cross- sectional observational study.

Place and Duration of Study: Department of Surgical Oncology, ESI-PGIMSR and Model Hospital, New Delhi from January 2021 to December 2022.

Methodology: Following approval by the ethical committee of our institution, a total of 100 patients with HNSCC were enrolled in the study. Clinic-demographic data (like age, sex, religion, primary tumor site, family history, exposure to risk factors, clinical staging, treatment received and recurrence) was collected from patients with histologically confirmed HNSCC. All patients with clinically and histologically confirmed HNSCC from North India were included in this study.

Results: Most of the patients were aged between 41-50 years (39%). 90% of the patients were Hindu, 6% Muslim, 3% sikhs and 1% Christian. Most of the patients (45%) were tobacco chewers, 21% had no history of tobacco consumption. 24% of the patients had alcohol intake as a risk factor, whereas 76% patients did not. Most of the patients (49%) presented with growth as a main concern. 46% patients reported ulcer as their presenting complaint. 4% patients had pain and 1% came with trismus. In oral cavity carcinomas, buccal mucosa was found out to be the most common subsite (41%) followed by tongue which was present in 26% of the total patients. Most of the patients presented with cN+ (41%) followed by 31% with cT2, 13% with c T4, 10% with c T3 and only 5% presented with c T1. 94 underwent surgery (13 patients received neo-adjuvant chemotherapy (NACT) before the surgery), 4 received definitive concurrent chemoradiotherapy (CCRT) and 2 were defaulter to treatment. Out of a total of 100 patients, 90 patients were followed up (mean 26.79 months) with clinical examination and radiological investigations (contrast enhanced computed tomography (CECT), magnetic resonance imaging (MRI), positron emission tomography- computed tomography (PET-CT) scan), whereas 10 patients were lost to follow-up. Later on follow-up it was found that 26.2% patients developed locoregional recurrence and 8.3% patients developed systemic/ metastatic disease.

Conclusion: The epidemiological profile of HNSCC in North India patients indicate a predominance of middle -age patients with smoking, tobacco chewing and alcohol as primary risk factors. With the rising incidence of head and neck squamous cell carcinoma (HNSCC) across Asia, particularly in India, comprehensive public health initiatives focusing on education and awareness—especially regarding modifiable risk factors such as tobacco use and alcohol consumption—are essential for effective prevention and reduction of disease burden. There is a need to implement strategies focused on prevention, early detection, and diagnosis of the disease.