Head and neck cancer in the South West of England: influence of socio-economic status on incidence and second primary tumours

This study examined possible links between the incidence of head and neck squamous cell carcinoma (HNSCC) and social deprivation. Data on all HNSCC registered between 1985 and 1991 in the South West of England were collected. Excluding tumours of the lip and skin there were 1570 cases, 72% in males. Of these, 1467 were identified as first primary tumours. Corrected chi-squared tests, accepting significance at the 5% level, were used to examine the association of socio-economic status (Carstairs index) with incidence at different sites. Overall, the incidence of HNSCC was higher in the socially deprived group. In males, the most deprived group had a significantly higher incidence of oral carcinoma than all other groups (P<0.05), whereas the incidence of laryngeal carcinoma showed a gradual rise with increasing deprivation. In females, where numbers were relatively low, the trend remained, but was less clear. In total, seventy-two (4.9%) cases went on to develop a second primary, of which 35% were in the lung and 13% in the bladder. Socio-economic status did not affect the development of a second primary tumour. The association of HNSCC with carcinoma of the bladder is a new finding.