Tracking Changes in Age Distribution of Head and Neck Cancer in the U.S.
from 1975-2016
Abstract
Introduction There is currently a lack of available data clearly
addressing whether the proportion of young patients diagnosed with head
and neck cancer (HNC) within the U.S. has increased over the last
several decades in comparison to other age cohorts. This study attempts
to elucidate any trends in oral cavity, oropharynx, larynx and
hypopharynx cancer age distribution in the United States population from
1975-2016. Unlike previous studies, this paper does not track incidence,
but rather reports proportional changes of prevalence within age cohorts
over time. Methods This is a retrospective chart review centered on data
from the Surveillance, Epidemiology, and End Results (SEER) Program of
the National Cancer Institute (NCI). Each decade interval from 1975-2016
displays the proportion of HNC patients, classified by primary tumor
subsite, within each age cohort. Results Mean age at diagnosis increased
for three of the four HNC evaluated. Oropharyngeal cancer was the only
subsite to demonstrate an overall proportional increase, mainly in
middle age (40-59 years) patients. Cancers of the oral cavity were the
only subset to show a true increase in the proportion of young (0-39
years) patients. When stratifying by gender, the proportion of young
patients in female HNC cases is higher than the proportion of young male
HNC cases. Conclusion Overall, this study demonstrates an increased
proportion of older HNC patients that is consistent with the aging
population. Oral cavity is the only cancer to demonstrate a true
increase in the proportion of young patients, likely from the increased
incidence of young women diagnosed with this cancer. Case reports citing
more young patients becoming diagnosed with other types of HNC are not
currently supported by the data. Lastly, the increased proportion of
middle-age patients with oropharyngeal cancer likely reflects the
increase in HPV-related cancers.