In Europe, survival was analysed from about 240,000 H&N cases diagnosed in 1999–2007 collected by 86 population-based cancer registries, in 29 countries [4].

There are some differences between clinical and population-based survival studies.

For the above reasons, descriptive survival figures are more properly taken from population-based than from clinical studies.

From Figs. 2.5, 2.6, and 2.7, 5-year relative survival is given by cancer site (tongue and lingual tonsil, oral cavity, oropharynx, nasopharynx, hypopharynx and larynx) and by country. Countries are ordered according to geographical region from North Europe to UK and Ireland, Centre, South and East of Europe, and different regions are highlighted by different grade of blue. Cases included in the analyses are those diagnosed between 2000 and 2007.

Five-year survival was the poorest for hypopharynx and the highest for larynx cancers, 25 % and 59 %, respectively (Fig. 2.5). Survival for tongue or oral cavity cancer patients were similar, 43 % and 45 %, respectively (Fig. 2.6). Five-year survival was slightly better for nasopharynx (49 %) and worse for oropharynx (39 %) (Fig. 2.7). For all these H&N, survival significantly reduced with the increasing age: from 56 % in the youngest age group of 15–44 years of age to 34 % in the oldest age group 75 and more years old (Table 2.2). Five-year survival was significantly better in female than male: 36 % and 50 %, respectively (Table 2.3).

H&N survival disparities were reported in Europe: for all the considered cancers, 5-year survival was low in the Eastern countries (Figs. 2.5, 2.6, and 2.7).

Five-year survival increased for some of the H&N. Between 1999 and 2007, survival significantly improved for hypopharynx, tongue, oral cavity, oropharynx (Figs. 2.8, 2.9, and 2.10). Improvement was marginally significant for nasopharynx (Fig. 2.10); for larynx, 5-year survival remained stable (Fig. 2.8).

To understand the impact on geographical differences of anatomical sub-site of origin of the lesion, the relative excess risk of dying (RER) was estimated by a model which included age, sex, country and sub-site. Tables 2.4, 2.5, and 2.6 show that for mouth-pharynx and larynx, after the inclusion of sub-site, as covariate, geographical disparities between countries slightly reduced. For larynx, with England as reference, all the northern countries, Germany, the Netherlands, Scotland, Italy, Slovenia and Spain were at lower risk, while Ireland and all the Eastern countries were at higher risk. For mouth-pharynx, the Nordic countries, Germany, Switzerland, the Netherlands and Italy were at lower, and Belgium, France, Slovenia, Spain and all the Eastern countries were at higher risk, again, considering England as reference. High risk was estimated, when comparing sub-sites, for hypopharynx, oropharynx and pharynx NOS, postcricoid region, with RER of 1.52, 1.53 and 1.62, respectively, with respect to the base of tongue, vallecular, and lingual tonsil (taken as reference) and the lowest for cheek plus vestibule of mouth (0.61) (Fig. 2.8). For larynx, all the anatomical sub-sites considered in the model (sovra- and sub-glottis), RERs were about three times higher than reference (glottis) (Fig. 2.9).