Epidemiology of head and neck cancer: magnitude of the problem.

Head and neck cancer comprises squamous cell carcinomas of the upper aerodigestive tract. There are similarities in their natural history, epidemiology and control. For these cancers premalignant changes can be identified. Smoking and drinking are the major risk factors. The geographical variations in incidence and mortality are indicative of differences in the prevalence of risk factors between countries. The dramatic increase in head and neck cancers is cause for great concern, particularly in Central-Eastern Europe. The great majority of these cancers could be prevented by reducing the prevalence of established risk factors. Screening could be used to detect both precancerous lesions and early invasive cancers; however, no study as yet has demonstrated a reduced incidence and mortality resulting from screening. When setting strategies for prevention, the socioeconomic differentials in incidence and mortality from head and neck cancers need to be taken into account.