Characterization of patients with head and neck cancer in Argentina.

Abstract

e23396 Background: Head and neck squamous cell carcinomas (HNSCC) arise from epithelial cells of the lip/oral cavity (OC), oropharynx (OP), nasopharynx (NP), hypopharynx (HP), and larynx (LX). In Argentina, an estimated 3,000 new head and neck cancer (HNC) cases and 1,600 deaths occurred in 2022. Robust, locally relevant epidemiologic profiles for HNC can strengthen clinical practice and policy planning. We conducted a sector-wide assessment of tumor site, TNM stage, and patient characteristics in Argentina to detail evidence-based care and guide future research. Methods: observational, retrospective, cross-sectional study (2017–2020) conducted at two Buenos Aires referral hospitals (public and private). Adult new cases of HNSCC (excluding NP carcinoma) were included. Data were collected via chart review; descriptive statistics summarized demographics and clinical factors. Results: The sample consisted of 300 incident cases (150 per site), of which 68% (205) were male, mean age was 59 (SD = 11), with 65% aged 50–69. Patients were 34%, 39% and 27% never, former and current smokers, respectively; 89% reported no alcohol use. Patients were most often first identified by otolaryngologists (35%) or general surgeons (32%). Oncologists were rarely the first contact (4%). Staging at diagnosis was 23% I, 16% II, 26% III, and 35% IV (18% IVA, 11% IVB, 5% IVC). Primary tumor locations were OP (37%), lip/OC (33%), LX (24%), and HP (6%). ECOG at first visit was 0 in 49%, 1 in 19%, 2 in > 3% and 3 in > 1%, with 28% being unknown. 104 (mostly oropharynx) had HPV testing: 82% (n = 86) were HPV positive. Among oropharyngeal tumors, 75% (n = 111) were HPV-positive, 17% (n = 19) were negative, and 8% (n = 9) unknownThe private center (Alexander Fleming) had more lip/OC cancers (43% vs 23%), more stage I diagnoses (31% vs 15%), higher HPV positivity in OP tumors (95% vs 73%), faster access (53% seen within ≤1 month vs 39% at public center; 6% > 2 years at the latter), and more first identification by general surgeons (59% vs 5%). The public center (Instituto Ángel Roffo) had more OP (41% vs 33%) and laryngeal cancers (29% vs 20%), roughly twice the HP tumors (7% vs 4%), higher stage III–IV (30% vs 22% for stage III; 39% vs 31% for stage IV; IVB 15% vs 7%), greater current smoking (37% vs 17%) and alcohol use (16% vs 7%), more first identification by otolaryngologists (43% vs 25%) and clinicians (27% vs 2%), and far more second-opinion referrals (89% vs 17%). Conclusions: This two-center analysis reveals distinct sectoral profiles: the private center exhibited faster access and more early-stage and HPV-positive oropharyngeal cancers, whereas the public center had longer delays, more advanced-stage disease, higher tobacco and alcohol use, and more laryngeal/hypopharyngeal tumors. Targeted interventions to accelerate diagnosis, harmonize HPV testing, and mitigate modifiable risks may help reduce late-stage presentations and access inequities in Argentina and comparable health systems contexts.