Determination of the characteristics and possible risk factors associated with squamous cell carcinoma of the hypopharynx at Kenyatta National Hospital

ABSTRACT

Introduction:

Head and neck cancer has been on the increase in the last few decades. Just as well hypopharyngeal carcinoma cases are increasing and patients younger than described in most literature are being diagnosed with the disease.  Patients presenting with hypopharyngeal carcinoma at Kenyatta National Hospital (KNH) are diagnosed at advanced stage of the disease due to late presentation. This is partly because of lack of awareness of symptoms and also lack of knowledge on the risk factors that predispose patients to developing hypopharyngeal cancer.

Objectives:  To determine the characteristics and possible risk factors in patients with squamous cell carcinoma of the hypopharynx at Kenyatta National Hospital.

Study Design: A hospital based descriptive cross – sectional study.

Study setting:  The study was carried out at KNH in the Ear, Nose and Throat ward and out-patient clinic, as well as the radiotherapy department. This was done after ethical approval from the KNH-University of Nairobi research and ethics committee.

Study population:  All patients over the age of 12 years with confirmed hypo pharyngeal carcinoma who gave consent and assent form for the study from the ENT clinic, ENT ward, and radio-therapy department. Sixty 9 cases were recruited for the study.

Methodology:  The study was carried out between June to October 2013. The patients' demographic data, medical history and physical examination findings were  recorded in a patient proforma. The characteristics and possible risk factors in each patient were obtained by means of a questionnaire.

Results: Mean age was 50.6years (SD = 15years) with majority 41(59.4%) being male. Majority of the patients presented in the 6th and 7th decade with 21(30.4%) and 16(23.1%) patients respectively. Dysphagia was present in 69(100%). Seventeen (24.6%) of the patients were exposed to farming chemicals with a mean duration of 30years of exposure. Use of water direct from the river was common in 66.6% of the patients. Smoking was present in 36(52.1%) patients and all were male with the commonest type being filtered cigarettes, 32(87.8%). Secondary smoke exposure in 15(23.8%). Alcohol consumption was present in 35(50.7%) of patients 30(93.8%) of which also smoked. Alcohol consumption was present in 35(50.7%) of patients of whom 30(93.8%) also smoked. Intake of fruits and vegetable was low among the patients. The most common histologic was moderately differentiated SCC with the postcricoid region being the most affected subsite.

 

Conclusion and recommendation: More studies need to be done to evaluate the real risk of certain environmental exposures as well as exposure to smoking, alcohol consumption and farming chemicals in areas most affected.

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