The emergence of the human papillomavirus (HPV) as the primary etiology of oropharyngeal cancer has changed head and neck cancer (HNC) epidemiology. This study described change in the age at diagnosis of oropharyngeal and non-oropharyngeal HNC in the United States in the last four decades. Using a retrospective cohort analysis, the Surveillance, Epidemiology, and End Results dataset from 1975 to 2016 was queried for eligible adult cases of HNC, grouped as oropharyngeal (n = 31,702) versus non-oropharyngeal (n = 87,108). Age at diagnosis was compared by gender (female, male) using independent t-test, and by race/ethnicity (Hispanic, non-Hispanic black, non-Hispanic white, non-Hispanic other) using analysis of variance. Joinpoint regression estimated yearly increases/decreases in age of diagnosis by sex and race/ethnicity through annual percent changes (APC), which were summarized with average annual percent changes (AAPC). Mean age at diagnosis for oropharyngeal cancer was 60.3 years. While there was initially a decrease in age at diagnosis, a 0.37% annual increase occurred from 2002 to 2016 (APC = 0.37, 95% confidence interval (CI) 0.28, 0.45). For non-oropharyngeal cancer, mean age at diagnosis was 63.2 years, with a continuous increase in age at diagnosis throughout the study period (1975–2016 AAPC = 0.08, 95% CI 0.04, 0.12). Females had higher average age at diagnosis than males for both sites, while blacks (57.4 years for oropharyngeal cancer; 59.0 years for non-oropharyngeal) had the lowest age at diagnosis of all races/ethnicity. Age at diagnosis of oropharyngeal cancer has increased significantly since 2002, while non-oropharyngeal HNC has increased significantly in the last four decades.

The fallopian tube has received attention as an origin of high-grade pelvic malignancies. This is a case of bilateral fallopian tube cancer discovered after an abnormal Pap test. A 62-year-old woman with a history of one term delivery had atypical glandular cells on a Pap test. She had an unsatisfactory colposcopy and a normal transvaginal ultrasound. A loop electrode excision procedure and hysteroscopy with dilation and curettage revealed atypical glandular cells concentrated in floating balls. CA-125 was 10 U/mL. A robotic hysterectomy revealed histopathological stage IIIA serous carcinoma arising from both fallopian tubes. She received six cycles of carboplatin and paclitaxel. After chemotherapy, she has no evidence of disease at 5 years. Fallopian tube carcinoma is a differential diagnosis of abnormal glandular cells on a Pap test. Diagnosis by systematic pursuit of abnormal tests can lead to successful treatment of a small disease burden.

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Introduction: Human papillomavirus (HPV) is the most common etiology of oropharyngeal squamous cell carcinoma (OPSCC), causing 70-90% of cases, and has continued to increase in incidence. While HPV-associated OPSCC has been associated with younger age at diagnosis compared to other head and neck cancers, research studies suggest that age of diagnosis might have increased in the last decade. There is currently no long-term, population-based estimate of age of diagnosis of oropharyngeal cancer, or differences in age of diagnosis based on race and gender. This study aimed to describe the change if any in the age of diagnosis of OPSCC in the last four decades. Methods: The mean age at diagnosis of OPSCC patients from the Surveillance, Epidemiology, and End Results (SEER) 9 database diagnosed from 1975-2015 was computed for each year (n = 30,320). An independent samples t-test compared mean age at diagnosis by sex (female, male), and analysis of variance compared mean age at diagnosis by race/ethnicity (Hispanic, non-Hispanic (NH) white, NH black, NH other). Joinpoint regression estimated yearly increases/decreases in mean age of diagnosis by sex and race/ethnicity through annual percent changes (APC), which were summarized with average annual percent changes (AAPC). Results: OPSCC patients were predominantly NH white (80.0%) and male (76.8%) with a mean age at diagnosis of 60.3 years (standard deviation = 10.9 years). Females had a significantly higher mean age at diagnosis than males (62.4 versus 59.7, p < 0.01). Hispanic (mean = 59.2) and NH black patients (mean = 57.3) had a significantly lower mean age at diagnosis than NH white patients (mean = 60.8). Overall, mean age at diagnosis remained stable from 1975-1996 (APC = 0.00, p > 0.05), significantly decreased from 1996-2002 (APC=-0.86, p < 0.01), and significantly increased from 2002-2015 (APC = 0.35, p < 0.01). However, the overall AAPC showed a stable trend in age of diagnosis from 1975-2015 (AAPC = -0.02, p > 0.05). The AAPCs in age of diagnosis for gender (males and females) and race/ethnicity also both remained stable from 1975-2015 (p > 0.05), except for NH blacks, with an estimated 0.13% yearly increase in age of diagnosis from 1975-2015 (AAPC = 0.13, p < 0.01). Conclusions: The overall age at diagnosis for OPSCC has remained stable in the United States between 1975 and 2015. The younger age at diagnosis among NH blacks and Hispanics is important in prevention, early detection, and surveillance of OPSCC in the United States Citation Format: Brittany J. Cline, Matthew C. Simpson, Aleksandr R. Bukatko, Eric Adjei Boakye, Kahee A. Mohammed, Nosayaba Osazuwa-Peters. Change in age of diagnosis of oropharyngeal cancer in the United States, 1975-2015 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5047.