The challenge of care in head and neck surgical oncology in Chile

Abstract

Malignant neoplasms of the head and neck affect various anatomical subsites, such as the skin, thyroid and parathyroid glands, temporal bone, oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, paranasal sinuses, and salivary glands. In 2018, head and neck cancer was the seventh most common cancer worldwide. The fundamentals of head and neck surgery have been developed worldwide by collaborators from different specialties, particularly coming from specialists in general surgery and otolaryngology. The latter being the main base specialty in developed countries. Despite the significant effort made by head and neck surgeons in Chile, who currently can only enter national fellowship training programs if they come from the base specialty of general surgery, the large gap between the incidence of head and neck cancer and the number of hours of care is a challenge. According to the "National Cancer Plan 2018-2028", the five high complexity oncology centers will be located in the regions with the best otolaryngologist per inhabitant ratio in the public system. In this context, it is reasonable to consider that following the trend in North America and other developed countries, a significant percentage of otolaryngologists could continue their training as sub-specialists in an area that Chile currently urgently needs, such as head and neck surgery.