Despite much belief to the contrary, tobacco control has been a major public health success over the last four decades. The number of adult American smokers has dropped from 42% in 1965 to 21% in 2004 and currently 58% of adults have never smoked. As a direct result of these changes, the incidence and mortality rates for head and neck cancer have steadily declined over at least the last 15 years. What impact will this trend have on the field of head and neck oncology? Will the field die out as a discarded cigarette does?
Explore this issue:July 2006
Moreover, most laryngeal and oropharyngeal cancers are curable today with chemoradiotherapy, and targeted therapy has the promise of further improving disease control. Does this improvement in treatment also mean a death knell for head and neck surgery? More and more otolaryngology residents seem to have lost interest in head and neck surgery as well, with more fellowship positions available than we can fill. Is there even going be a need to train head and neck surgeons in the foreseeable future?
The answer is unequivocally YES, but the question remains—how should they be trained?