Rising incidence of late‐stage head and neck cancer in the United States

Abstract

Background The current study was conducted to determine whether the incidence of late‐stage head and neck cancer (HNC) is decreasing and to estimate the risk of late‐stage HNC diagnosis based on race and sex. Methods Age‐adjusted incidence rates for patients aged ≥18 years with stage IV HNC were abstracted from the Surveillance, Epidemiology, and End Results database (2004‐2015). Rates were stratified by race, sex, and age. Joinpoint regression estimated annual percent changes (APCs) in rates over time, and logistic regression estimated adjusted odds ratios (aORs). Results There were 57,118 patients with stage IV HNC in the current study cohort, with an average age of 61.9 years. From 2004 to 2015, the age‐adjusted incidence rates for stage IV HNC significantly increased by 26.1% (6.11 per 100,000 person‐years in 2004 to 7.70 per 100,000 person‐years in 2015). White and Asian/Pacific Islander/American Indian/Alaska Native patients had significant increases in incidence (APC for white patients, 3.03 [P < .01] and APC for other races, 1.95 [P < .01]), whereas rates among black patients remained stable but were highest across racial groups. Incidence was higher among males compared with females. When restricted only to patients with stage IVC (metastatic) HNC, there remained a significant increase in incidence, especially for oropharyngeal cancer, which showed a 22.9% increase (0.21 per 100,000 person‐years in 2004 vs 0.25 per 100,000 person‐years in 2015). Despite a decreasing overall incidence of stage IV HNC in black patients (aOR, 1.28; 95% CI, 1.22‐1.34) they, along with males (aOR, 3.95; 95% CI, 3.80‐4.11), had significantly increased risks of being diagnosed with late‐stage HNC. Conclusions There is an increasing incidence of late‐stage HNC in the United States, with male patients and black individuals faring the worst.

Incidence and Survival of Head &amp; Neck Cancers in Estonia, 1996–2016

“…Signi cantly later stage at diagnosis for mouth & pharyngeal cancers among men compared to women (proportion of stage IV tumors 65% in men and 52% in women, p < 0.001, data not shown) is one potential explanation. Male sex has been found to be a predictor of late-stage head & neck cancer, together with increased age, black race, absence of health insurance and tumor site [4]. A signi cant female survival advantage was found in Estonia for ve of the nine studied common solid tumors, including mouth & pharyngeal tumors, even after adjusting for age, stage and subsite, suggesting the role of less co-morbidities, higher treatment compliance and better health behavior among women [46].…”

“…Decreasing use of tobacco has brought along declining trends of oral and laryngeal cancer, whereas growing burden of HPV infection has caused increasing rates of oropharyngeal cancers [2,3]. Furthermore, there have been reports of rising incidence of late-stage oral and pharyngeal cancers [4]. Thyroid cancer trends are deeply affected by wide-spread diagnostic activities and the detection of indolent tumors in many highly developed countries [5][6][7].…”

Survival Benefits From Surgery for Stage IVa Head and Neck Squamous Cell Carcinoma: A Multi-Institutional Analysis of 1,033 Cases

“…The prognosis of these patients is poor. Furthermore, between 2004 and 2015, the incidence rate for stage IV HNSC increased significantly, by 26.1% [3,4].…”

The use of free chimeric flaps in head and neck reconstruction: technical pearls and clinical applications

“…Head and neck tissue defects may result as a consequence of severe traumas or, more frequently, after ablative oncologic procedures. The increasing age of the population and the widely diffused smoking habits are causing a remarkable number of these cases throughout the world [1] .…”