Pattern of Head and Neck Cancer Referrals to Oncology Services from Oral and Maxillofacial Surgery Units in Northern Nigeria

Head and neck cancers, including oral squamous cell carcinoma, salivary gland malignancies, and jaw osteosarcomas, require multidisciplinary oncological management involving surgery, radiotherapy, and chemotherapy. In northern Nigeria, where cancer services are concentrated in a small number of tertiary centers, referral of head and neck cancer patients from oral and maxillofacial surgery units to oncology services faces significant structural and geographic challenges. This retrospective multi-center study analyzes the pattern, timeliness, and outcomes of head and neck cancer referrals from oral and maxillofacial surgery units in the North West and North Central geopolitical zones to oncology departments or cancer centers. Case records of 124 histologically confirmed head and neck cancer patients managed between 2020 and 2023 across four institutions were reviewed. Data include time from diagnosis to oncology referral, stage at referral, referral route, treatment received, and six-month survival outcome. Results reveal a median time of 8.4 weeks from confirmed diagnosis to oncology referral, significantly exceeding recommended thresholds. Most patients presented at stage III or IV disease. Forty-two percent of referred patients did not attend their oncology appointment due to financial constraints, distance, or distrust of cancer treatment. The study advocates for integrated head and neck oncology tumor boards at northern Nigerian tertiary institutions and increased access to cancer treatment subsidies through the Basic Health Care Provision Fund. Keywords: head and neck cancer, oncology referral, northern Nigeria, squamous cell carcinoma, multidisciplinary care.