Background: The difficulties in the surgical management of cancer of the head and neck region when they present late cannot be underestimated. In Nigeria, as it is often the case with most developing countries, a viscous chain reaction of poverty, superstition, ignorance, poor health-seeking behaviour and limited options of treatment result in patients default for late presentation. This paper identifies and brings into focus the reasons for late presentation of head and neck cancers in Nigeria.

Methods: The case notes of sixty-eight patients with inoperable head and neck lesions diagnosed as cancer seen in Enugu, Nigeria between January 2003 and December 2009 were retrieved and analyzed. Data collected include socio-demographic data, diagnosis, time-interval before presentation, reasons for late presentation and treatment outcome.

Results: A male-to-female ratio of 1.5:1 was obtained. Out of the 68 patients, the most occurring lesion was squamous cell carcinoma ( n = 43; 63.2%). All presented at the late stage of the lesion. The major reasons for late presentation were poverty ( n = 29; 42.6%), ignorance of the disease ( n = 12; 17.6%), non-availability of medical personnel and treatment by quacks ( n = 14; 20.6%), preference for unorthodox treatment ( n = 9; 13.3%) and family decisions ( n = 4; 5.9%). None of the patient survived.

Conclusion: There is need for early detection of head and neck cancer to reduce the morbidity and mortality associated with late presentation. We therefore recommend an urgent awareness campaign and programmes not only for early detection but also for prevention and provision of hospitals with modern facilities for adequate and effective treatment.

Conflict of interest : None declared.