Head and Neck Cancer in Haiti: A Case Series from Hopital de L'Universite d'Etat d'Haiti.

Abstract

This manuscript characterizes the demographics, presenting symptoms and risk factors of patients diagnosed with head and neck cancer at Hopital de L'Universite d'Etat d'Haiti (HUEH), Haiti's single largest healthcare facility. We conducted a prospective study of patients who presented to HUEH between January and March of 2016 with a lesion of the head or neck suspicious for cancer. All patients who met eligibility criteria received a biopsy, which was interpreted by a Haitian pathologist and when the specimen was available was confirmed by a team of pathologists from Stanford University. A total of 34 participants were identified. The biopsy-confirmed diagnoses were squamous cell carcinoma (n=7), benign (n=7), large cell lymphoma (n=2), ameloblastoma (n=2), pleomorphic adenoma (n=1), and adenocarcinoma (n=1). Fourteen patients were unavailable for biopsy. Patients with head and neck cancer had a mean age of 63.4 years, were majority male (62.5%), waited on average 10.9 months to seek medical attention, and most commonly presented with T-stage 3 or higher disease (87.5%). By characterizing patterns of head and neck cancer at HUEH we hope to facilitate efforts to improve early detection, diagnosis, and management of this important public health condition.

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Published Version (Please cite this version)

10.1155/2018/9429287

Publication Info

Kligerman, Maxwell P, Anahuma Alexandre, Patrick Jean-Gilles, David K Walmer, Adam J Gomez, Christina S Kong, Mack L Cheney, Murray A Mittleman, et al. (2018). Head and Neck Cancer in Haiti: A Case Series from Hopital de L'Universite d'Etat d'Haiti. International journal of otolaryngology, 2018. p. 9429287. 10.1155/2018/9429287 Retrieved from https://hdl.handle.net/10161/22237.

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Scholars@Duke

David Keith Walmer

Adjunct Professor of Global Health

My areas of interest include
women's health in Haiti
- cervical cancer prevention
- maternal child health
- hypertension 

GLOBAL HEALTH

Preventing cervical cancer in Haiti 
Goal: Develop culturally acceptable and cost effective strategies to prevent cervical cancer
Current strategy:
- primary screen: HPV testing
- treatment thermal ablation of the cervical transformation zone in HPV+ women
Under investigation
- strategies to remove inflammatory cells from cervical cytology
- strategies to speed up and improve AI interpretation of cervical cytology
- strategies to employ drones to deliver test kits and patient samples to deliver health care in gang controlled areas

Improving maternal child health in rural Haiti
- establishing 24/7 access to L&D services in a remote mountain community



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