The current research on the epidemiology of head and neck cancer in Africa: practice implications for African speech therapists

Abstract

Background: Over the last decade, limited research has been done on the determinants and distribution of head and neck cancer (HNC) within an African context, or the role of the speech therapist (ST) in treating this population. The current study intended to fill this caveat, and highlight potential implications for STs from the epidemiological information. Method: The main aim of the current study was to document the current epidemiological HNC research in Africa via a systematic review. The inclusion terminology pertained to the types; stages; signs and symptoms, and risk factors/comorbidities of people with HNC living in Africa, the treatment protocols being implemented, as well as demographic data. The following databases were consulted: PubMed, EBSCO, Scopus, Web of Science, Sabinet, and Google Scholar, as well as grey literature sources. Information was analysed with descriptive statistics, a narrative synthesis, and thematic analysis. Results: Sixty-six articles met the inclusion criteria, and were used for analyses. The most prevalent cancer type was oral cancer/oropharyngeal cancer (OC/OPC) (74%). HNC’s were diagnosed in the late stage, and signs and symptoms were severe in nature. Substance abuse remains the highest reported risk factor, and there has been a rise in infectious diseases as a risk factor. Surgical resection remains the primary medical intervention in Africa, whilst chemotherapy and radiation services remain limited. Conclusion: HNC in Africa is a growing problem. Risk factors vary across regions and are increasing, particularly infectious diseases. The lack of resources and education has led to severe and advanced stage disease, with limited medical intervention. Implications: There are implications for the role of the ST in treating HNC in Africa, in the type and intensity of treatment provided; and the role in community education programmes. The review highlighted the need for STs where HNC is increasing, thereby informing policy makers and governments of the need for STs, and education programmes across Africa.