Trends in cancer of the head and neck in the elderly in Denmark, 1980–2012

Abstract

Background Squamous cell carcinoma of the head and neck (HNSCC) comprises a variety of malignant tumors. Due to the rarity of each individual malignant entity, knowledge of epidemiological changes and trends over time may be derived from data compiled in regional and national registries. This study analyzed the development in incidence rates and mortality in elderly HNSCC patients in Denmark between 1980 and 2012 with specific attention to compliance to radiotherapy, the main treatment modality of HNSCC in Denmark. Material and methods HNSCC consisting of more than 25 patients per year over the age of 70 years were analyzed. This included cancer of the oral cavity defined as ICD-codes C00.3-4, C02-04, C05.0, C06; oropharynx as C01, C05.1-9, C09-10; and larynx as C32 recorded in the NORDCAN database. Additional data from the DAHANCA database was added to assess differences in compliance to treatment between younger and older patient groups. Results HNSCC was predominant in younger patients. Only 17% were older than 70 years. The median age was 60 years. Generally, incidence rates rose for cancer of the oral cavity and oropharynx between 1980 and 2012 and stabilized for laryngeal cancer. Mortality rates had a shallower increase, especially in younger age groups, which translated into improved age-specific survival rates. Compliance to radiotherapy was high for all age groups. Failure to receive at least 60 Gy during radical radiation treatment was 2.3% despite a significant increase in patients with poor WHO performance status over time. Conclusion HNSCC is a rare disease in patients above 70 years accounting for only 17% of all HNSCC patients. Incidence rates increased over time, but age-specific survival rates improved, especially in younger patients. Failure rates to comply with radiation treatment, however, were low in both young and elderly patients.

Postoperative Radiochemotherapy Using Modern Radiotherapy Techniques in Elderly Patients with Head and Neck Squamous Cell Carcinoma: The Challenge of Weighing Up Benefits and Harms of Treatment Modalities in Clinical Practice

“…In elderly patients, HNSCC are rare [ 9 ]. Less than 20% of HNSCC patients get diagnosed at the age of >70 years [ 9 ].…”

“…In elderly patients, HNSCC are rare [ 9 ]. Less than 20% of HNSCC patients get diagnosed at the age of >70 years [ 9 ]. At the same time, regarding the general increase in life expectancy, the proportion of elderly patients with HNSCC is expected to grow rapidly [ 1 , 10 ].…”

Evolution of the Incidence of Oral Cavity Cancers in the Elderly from 1990 to 2018

“…A Danish study showed an increase in OCC incidence in men and a stabilization among women for all age groups from 1980 to 2012. For both sexes, incidence rates were the highest in the population aged 70 years or more [23]. The Dutch national incidence data (https://iknl.nl/nkr-cijfers (accessed on 1 October 2021)) also show an increase for both sexes (age groups 70-74, 75-79, 80-84, and >85 years).…”

“…Recent literature regarding this matter has mainly focused on the incidence surge among young subjects (<45 years) worldwide, but also in France, and seems to imply the involvement of unknown RF [20,21]. However, American and European studies also suggested a trend for a rising incidence among elderly subjects, with a limited association with smoking and alcohol abuse [11,22,23].…”