Dennis Ricardo August Mans , Jerry Radjinderdath Toelsie , Robbert Bipat , Rakesh Bansie , Martinus Albert Vrede
Back ground: The development of head and neck cancers is associated with extensive use of tobacco and/or tobaccolike products and alcohol; excessive consumption of processed meat and fish; exposure to certain occupational hazards; and infection with certain oncogenic viruses. At least some of these risk factors are operative in the Republic of Suriname. This suggests that the population may run a greater than average risk for head and neck cancers. In this study, the incidence of this group of cancers in Suriname has been determined for 1980 through 2004. The data obtained have been stratified according to anatomical location, gender, age, as well as ethnic background, and compared with global values.
Methods and findings: Numbers of diagnoses and patient information were from the Pathologic Anatomy Laboratory. Relevant population data were provided by the General Bureau of Statistics. Crude and/or sex-specific incidence rates were calculated for head and neck cancers overall as well as for all anatomical sites (oral cavity; salivary glands; nasal cavity and paranasal sinuses; nasopharynx, oropharynx, as well as hypopharynx; and larynx), and were stratified according to gender, age strata 0-19, 20-49, and 50+ years, and the largest ethnic groups, viz. Hindustani, Creole, and Javanese. From these data, average incidence rates were calculated which were expressed as means ± SDs per year, per 100,000 population per year, or per 100,000 males or females per year. Average yearly crude rates for head and neck cancers overall were approximately 4, and average yearly sex-specific rates about 5 in men and 2 in women. The most common sites were oral cavity, nasopharyngeal, and laryngeal cancer, occurring at average frequencies of about 4, 3, and 3 cases, respectively, per year. Overall head and neck cancers as well as most anatomical sites were 2-3 times more common in men than in women, increased strongly with older age, and manifested about 2.5 times more often in Creole than in Hindustani or Javanese. The exceptions were laryngeal cancer that displayed a male-to-female ratio of almost 6 to 1, and nasopharyngeal cancer, the age-dependent rise in incidence of which was more gradual than that for oral cavity and laryngeal cancer, and that occurred more often in Javanese.
Conclusions: The results from this study suggest that Suriname is a low-risk country for head and neck cancers. These tumors were in general more common in men than in women, occurred more often at older then at younger age, and manifested more frequently in Creole than in Hindustani and Javanese. Nasopharyngeal cancer, however, may have a predilection for Javanese. Detailed followup studies in Suriname’s cultural, religious, and ethnic diversity may help improve our understanding of head and neck cancer etiology.
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