The changing face of Irish head and neck cancer epidemiology: 20 years of data

Abstract

Background Head and neck cancer (HNC) is associated with significant morbidity and mortality, especially when high stage disease is present. The epidemiology and prognosis of HNC has changed considerably over the last 20 years. Aims This study aimed to examine the epidemiological trends in HNC patients over a prolonged period in Ireland. Methods We conducted a retrospective cohort study using 20 years of cancer registry data provided by the National Cancer Registry of Ireland. Baseline characteristics and survival statistics were thereby generated. Results 10,148 patients were identified. There is a growing population of young (< 50 years) and very old (> 85 years) HNC patients; 48.15% of the population was elderly (> 65 years). Oral cavity (29.8%) and laryngeal cancer (28.1%) remain the most prevalent subsites, though oral cavity cancer prevalence declined from 35.9% in 1994 to 27.5% in 2014. Oropharyngeal cancer prevalence increased from 13.6 to 22.2% over the same period. Overall 5-year survival has improved significantly to 56.8% in 2010 but there remains a disparity between the elderly and adult cohorts (42.0% vs 60.7%). 5-year survival for hypopharyngeal and oropharyngeal cancers has improved from 11.8% and 33.3% to 22.2% and 44.8%, respectively, while laryngeal and oral cavity cancer survival remains approximately stable at 58.7% and 61.5%, respectively. Conclusion HNC survival in Ireland has improved in line with increasing recognition of the value of multidisciplinary assessment, subspecialisation in cancer care, and targeted therapies based on tumour subsites. Survival in the elderly cohort remains poor despite increasing recognition of the challenges such cases pose.

Human papillomavirus and p16INK4a in oropharyngeal squamous cell carcinomas: A systematic review and meta‐analysis

“…So that, we estimated AF of HPV for oropharyngeal SCC by geographic region. We found that in more developed regions (ie, North America, Oceania, and Europe), AFs of HPV were higher than those in less developed region (ie, Asia, Latin America, and Africa), which was in line with the upward trend of HPV prevalence in these developed countries, such as the United States, 32,33 Australia, 30 Ireland, 27 Netherland, 28 and Denmark. 29 Especially in North America and Oceania, more than 60% of oropharyngeal SCC cases were attributable to HPV infection, which has become the most common cause of oropharyngeal SCC.…”

“…Between 2012 and 2021, HPV‐related oropharyngeal SCC continued to increase in Europe and Oceania which was mentioned above. Upward trend of HPV‐related oropharyngeal SCC was reported in many countries in Europe and Oceania 27‐30 . Changes in HPV prevalence in Asia, Europe, and Oceania may lead to these differences.…”

“…Upward trend of HPV-related oropharyngeal SCC was reported in many countries in Europe and Oceania. [27][28][29][30] Changes in HPV prevalence in Asia, Europe, and Oceania may lead to these differences. Our findings indicated the HPV prevalence in oropharyngeal SCC in Africa was 35.8%.…”

Age Alone Is Not a Barrier to Concurrent Chemoradiotherapy for Advanced Head and Neck Cancer

“…The survival statistics in this group strongly resembled that of stage III and IV disease, and is further described in another publication. 35…”

“…The survival statistics in this group strongly resembled that of stage III and IV disease, and is further described in another publication. 35 Finally the retrospective nature of the data limits further conclusions that can be drawn from this large dataset. Despite this, there is emerging recognition that observational data offers significant advantages over randomized controlled data where HNC research is concerned.…”