Head and neck squamous cell cancers in the United States are rare and the risk now is higher among white individuals compared with black individuals

Abstract

Background The increasing incidence of oropharynx squamous cell cancer (OPSCC) is well established. However, up-to date incidence estimates and trends for head and neck squamous cell cancers (HNSCC) overall including major anatomic sites and non-oropharyngeal (non-OP) HNSCCs by sex, race and age in the United States (US) are not well described. Methods Retrospective analysis of incident HNSCCs during 1992-2014 using Surveillance, Epidemiology, and End Results (SEER) database was used to evaluate incidence of HNSCCs overall, OPSCC and non-OP HNSCC (larynx, oral cavity, hypopharynx, nasopharynx, nasal cavity). Incidence rates were calculated overall and by subgroups of interest, and incidence rate ratios (IRR) were used to compare rates between groups. The incidence rates presented are per 100,000 people and age-adjusted to the 2000 US Standard Population (19 age groups – Census P25-1130). Annual percent change (APC) was modeled with and without joinpoints Results Incidence of HNSCC overall declined (average APC [aAPC] -0.8, p<0.001) in spite of significant increases in incidence of OPSCCs, most notably between 2000-2014 (APC=2.1, p<0.001). Indeed, significant declines in incidence were observed for all non-OP HNSCC sites, for both women and men (each p<0.001). Among women, risk of OPSCC also significantly decreased (aAPC -0.8, p=0.002), while among men OPSCC risk was stable during 1992-2001 (APC 0.4, p=0.42), then significantly increased during 2001-2014 (APC 2.7, p<0.001). Decreases in non-OP HNSCC risk were especially large for Black women (aAPC -2.6, p<0.001) and men (aAPC -3.0, p<0.001). While incidence of HNSCC used to be highest among Blacks, since 2009 HNSCC incidence is higher among Whites than Blacks. Conclusions Incidence of HNSCC is declining, especially for non-OP HNSCC and Blacks.

The prevalence of human papillomavirus in oropharyngeal cancer is increasing regardless of sex or race, and the influence of sex and race on survival is modified by human papillomavirus tumor status

“…6,19 By contrast, in the present study, the rate of increase in prevalence of HPV-associated tumors from 2010 to 2015 was similar among men and women and was significantly higher in blacks versus whites. 6,19 By contrast, in the present study, the rate of increase in prevalence of HPV-associated tumors from 2010 to 2015 was similar among men and women and was significantly higher in blacks versus whites.…”

“…Available population-based analyses indicate that the incidence of OPC is rising among men and whites but is decreasing among women and blacks in the United States. 6,19 By contrast, in the present study, the rate of increase in prevalence of HPV-associated tumors from 2010 to 2015 was similar among men and women and was significantly higher in blacks versus whites. Unfortunately, HPV tumor status is not available in SEER or other population-based datasets from which incidence is estimated, and the accepted proxy has been anatomic site.…”

“…Such changes would likely reflect the same epidemiologic factors that underlie the rise in HPV-OPC among white men, such as an increase in the oral sexual behaviors associated with exposure to oral HPV, and a concomitant decrease in the tobacco use that is responsible for most HPV-negative OPCs. [19][20][21] The clinical importance of these epidemiologic findings is that in the United States, individuals with an incident OPC, independent of sex or race, are now most likely to have a tumor etiologically associated with HPV. This is in contrast to other countries with much lower prevalence of HPV-positive tumors.…”

Proton Therapy for Locally Advanced Oropharyngeal Cancer: Initial Clinical Experience at the University of Washington

“…Additionally, recent epidemiologic data suggest that the risk of OPSCC is 4-fold higher among men than women. It also reported a significant increased risk among whites and a corresponding decreased risk among blacks between 2005 and 2014 [44]. In our institutional head and neck practice, patients with OPSCC were treated with either proton therapy or IMRT during the study period.…”

Prevalence of Human Papillomavirus Associated with Head and Neck Squamous Cell Carcinoma in Jordanian Patients

“…HPV detection and genotype identification were carried out using Real-time PCR (RT-PCR) thermal cycler (Bioer, China). REALQUALITY RQ-Multi HPV detection is an in vitro diagnostic kit (AB ANALITICA, Italy) which is capable of identifying 28 HPV types including 14 high-risk (16,18,31,33,35,39,45,51,52,56,58,59,66,68), 6 potential high-risk (26,53,67,70,73,82), and 8 low-risk (6,11,40,42,43,44,55,83) genotypes [14]. The kit amplifies a fragment in the region of E6 and E7 in the HPV genome and detects the different genotypes as a pool except for HPV 16 and HPV 18 which are detected individually.…”