![]() Therefore, reliable point-of-care diagnostic tests for HNC are urgently needed to improve survival, to reduce the need of mutilate surgery and, hence, to minimise the impact of HNC and HNC treatment on everyday functioning. In addition, HNC patients often develop a second primary cancer with an annual rate of 3–7% that is usually located again in the head-and-neck area or in the lung, making lifelong follow-up of HNC survivors necessary ( Ridge et al, 2010). Overall cure is achieved in <50% of all patients, despite recent advances in surgery and radiotherapy ( Goerner et al, 2010). ![]() Long-term survival rates for advanced HNC are low and have not improved significantly over the last decades ( Schweitzer et al, 2010). ![]() Two thirds of the patients are diagnosed with locally advanced or metastatic disease (stages III and IV) ( Nagaraj, 2009). Head-and-neck cancer lacks specific symptoms and has a large number of clinical phenotypes so that patients often turn to a general practitioner or a dentist first, instead of a HNC specialist. A general medical evaluation has to be performed, including a thorough head-and-neck examination by one or more physicians, followed by contrast-enhanced computed tomography (CT) and/or magnetic resonance imaging (MRI), and biopsies ( Mendenhall et al, 2008). The diagnosis of HNC is not trivial and requires specialist settings. Head-and-neck cancer is a particularly distressing human cancer, because both disease and treatment profoundly interfere with everyday functioning such as eating, breathing, and speech, and may lead to severe disfigurement ( Hanna and Sherman, 1999). More than 90% of all HNCs are squamous cell carcinoma that arise from mucosa lining the oral cavity, oropharynx, hypopharynx, larynx, sinonasal tract, and nasophaynx ( Pai and Westra, 2009 Marur et al, 2010). It comprises a group of diverse tumour types arising from various anatomic structures including the craniofacial bones, soft tissues, salivary glands, skin, and mucosal membranes ( Pai and Westra, 2009). Head-and-neck cancer (HNC) is the eighth most common cancer worldwide and a major cause of cancer mortality ( Parkin et al, 2005 Pai and Westra, 2009).
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