Management of head and neck cancer around the world: an international survey by the world ear, nose, and throat federation.
Publication/Presentation Date
11-3-2025
Abstract
OBJECTIVES: To evaluate worldwide medical practices of otolaryngology centers in managing patients with Head And Neck Cancer (HNC) MATERIALS AND METHODS: We performed an online survey sent to otorhinolaryngologists worldwide via the IFOS between February and March 2024. The following aspects were evaluated: personal characteristics, diagnostics modalities, treatments, global management, cultural specificities and clinical cases. We compared results between centers in different geographical areas: Europe, North America, South and Central America, Asia, Africa Sub-Saharan, Oceania, and Middle East & North Africa (MENA).
RESULTS: A total of 566 otorhinolaryngologists from 457 centers in 101 countries responded. International guideline adherence was lower in North America (45.5 %) than globally (74.5 %; p = 0.005). HPV/p16 testing was less common in Africa (28.9 %) and MENA (60.8 %) versus other regions (92.8 %; p < 0.001). PD-L1 testing was frequent in Europe (84.6 %) but rare in Africa (5.3 %; p < 0.001). Multidisciplinary Tumor Boards were systematic in Europe (88.9 %) and Oceania (87.5 %) but used selectively elsewhere. Intensity-modulated radiation therapy use was lower in Africa (28.9 %) and MENA (64.6 %; p < 0.001). A total of 95.7 % of centers had access to chemotherapy, with no differences between regions (p = 0.236). African centers cited cost as a major barrier (79.5 % vs. 33.8 %; p < 0.001). MRI and PET/CT access was significantly lower in Africa (51.2 % and 5 %), Central/South America (79.5 % and 47.7 %), and MENA (80.9 % and 43.8 %) than other regions (89.5 % and 73.2 %; p < 0.001).
CONCLUSION: The management of HNC exhibits significant variability worldwide. International guidelines should consider the economic, cultural, and geographic specificities of each continent to ensure context-sensitive care.
Volume
171
First Page
107766
Last Page
107766
ISSN
1879-0593
Published In/Presented At
Maso, V., Lechien, J. R., Gengler, I., Chiesa-Estomba, C., Fagan, J. J., Hao, S. P., Kowalski, L. P., Lyons, B., Babin, E., Mohd Razif, M. Y., Marzouki, H. Z., Macias, A. R., Ruiz, H. E., Maniaci, A., Fraysse, B., White, M., Michel, J., & Fakhry, N. (2025). Management of head and neck cancer around the world: an international survey by the world ear, nose, and throat federation. Oral oncology, 171, 107766. Advance online publication. https://doi.org/10.1016/j.oraloncology.2025.107766
Disciplines
Medicine and Health Sciences
PubMedID
41187612
Department(s)
Department of Surgery
Document Type
Article