INHANCE Consortium

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ABSTRACT Each year almost 600,000 head and neck cancers (HNC) cases are diagnosed and 325,000 deaths occur due to HNC in the world. HNC are a group of malignant cancers in the oral cavity, oropharynx, hypopharynx and larynx. They are studied together due to their shared risk factors of tobacco and alcohol, but they each have distinct epidemiologic and clinical features. For instance, human papillomavirus (HPV) infection is a strong risk factor specifically for oropharyngeal cancers and is contributing to it’s increasing incidence. The International Head and Neck Cancer Epidemiology (INHANCE; http://www.inhance.utah.edu) Consortium, established in 2004, is a very productive consortium with an excellent record of collaboration on HNC research. Although great advances have been made in HNC research to identify lifestyle risk factors and genes, challenges include subsite groupings and research results that are more directly relevant to patients. Our meeting will bring together the world’s experts on HNC epidemiology with the following aims: 1) to establish a Head and Neck Cancer Subsite Grouping Consensus Panel, 2) to discuss the potential of population-based head and neck cancer patient cohorts on providing information that patients and clinicians need and 3) head and neck cancer research in low and middle income countries (LMIC). The HNC subsite groupings have evolved over the decades, but not all researchers in the field have adopted the new groupings. Various cancer registry reports to this day include nasopharyngeal cancers and salivary gland cancers as ‘oral cavity and pharynx’ cancers. Combining such distinct diseases together is inappropriate and creates confusion for cancer trends and risk factors. The Consensus Panel will draft a paper to propose the subsite groupings for future studies. Additionally, although the INHANCE consortium has traditionally focused on identifying risk factors, studies that provide basic information for HNC patients is an area that epidemiologists can contribute to significantly with robust population-based studies. The current NCCN survivorship guideline states “The exact prevalence of various effects of cancer and its treatment are hard to quantify, because few studies have addressed these issues in a longitudinal fashion. In general, the prevalence of late effects in cancer survivors in believed to have increased over time, likely because anticancer interventions have become more complex and intense …”. We will discuss potential future studies, collaborations, and priority hypotheses for HNC patient cohorts with a focus on late effects among cancer survivors. HNC epidemiologists have great potential to contribute to clinical guidelines such as the NCCN for HNC survivors and possibly for treatment decisions when late effects due to treatments are characterized appropriately in well-designed epidemiologic studies. Finally, the majority of head and neck cancer cases are diagnosed in LMICs, but the majority of research is conducted in high income countries. We will discuss the high priority areas of research for head and neck cancer in LMIC for maximal impact to reduce the morbidity and mortality of this disease in LMICs.