Advanced head and neck cancer: proportionally higher in southland than Otago.
To compare the proportion of advanced head and neck cancer presenting from Otago and Southland, and to discuss any differences observed. Retrospective review of 186 patients resident in Otago and Southland who presented with a head and neck squamous cell carcinoma to the department of otolaryngology, Dunedin Hospital, between 1985-95. Otago patients had advanced disease in 43% of cases, compared to 66% in Southland patients (p = 0.004). Patients from rural Southland areas had advanced disease in 88% of cases. The incidence of cases was not significantly different between Otago and Southland. No difference was seen in local tumour size, however, Southland had a significantly higher rate of lymph node metastases (p = 0.0003). No difference was also seen in age, gender, duration of presenting symptoms, or delay in referral or diagnosis. Southland had a significantly higher proportion of advanced head and neck cancer than Otago. Significant differences in access to tertiary health care could not be found. The reasons for the differences observed were unclear.