FIGURE 7.1 Anatomy of the pharynx showing its proximity to the oral and nasal cavities and to the larynx and esophagus.

SOURCE: Copyright 2005 American Cancer Society, Inc. Reprinted with permission from www.cancer.org.

at the rate of about one cancer per 100,000 per year, whereas the incidence is high in southern China (30-50 per 100,000 per year), among Eskimos in the Artic region, and among some indigenous populations in Southeast Asia. The risk is 2-3 times higher in men than in women. Risk factors include Epstein-Barr virus (Mueller 1995), consumption of salted fish (Miller et al. 1996), and occupational exposure to formaldehyde (IARC 1995). There are three histologic types: keratinizing squamous-cell carcinoma, non-keratinizing carcinoma, and undifferentiated carcinoma.

Carcinoma of the hypopharynx is an uncommon disease. Considered collectively with carcinomas of the cervical esophagus, they make up about 10% of all tumors of the upper respiratory tract and digestive tract and less than 1% of all cancers diagnosed in the United States each year (Pfister et al. 2004). By far the most common histology is squamous-cell carcinoma. Cervical esophageal squamous-cell cancer and hypopharyngeal cancer typically present as extremely advanced disease, and 5-year survival is about 17-30%. Standard therapy for advanced disease is a combination of chemotherapy and radiation (Lefebvre et al. 1996). The major risk factors for



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