Evolving trends in head and neck cancer epidemiology: Ontario, Canada 1993-2010.

Abstract

Given the dramatic changes in global head and neck cancer epidemiology, the purpose of this study was to present the findings of our investigation on patterns of head and neck cancer incidence/survival within the province of Ontario, Canada. Temporal variations in age/sex adjusted incidence and survival were analyzed for all incident head and neck cancer cases (n = 20 781) managed within Ontario from 1993-2010. From 1993-2010, the incidence of oropharyngeal (average annual percentage change [AAPC] 4.56%; P < .001) and salivary gland (AAPC 4.99%; P < .001) carcinomas increased, whereas oral cavity (AAPC -1.44%; P < .001) and laryngeal/hypopharyngeal (AAPC -3.20%; P < .001) carcinomas declined, and nasopharyngeal carcinoma (NPC) remained static (AAPC 0.28%; P = .72). A general trend for improved 5-year overall survival (OS), was observed for all tumor sites. Consistent with previous studies, our results suggest a simultaneous decline in tobacco-associated and increase in human papillomavirus (HPV)-mediated carcinomas. The rising incidence of salivary malignancy and improvement in 5-year OS are novel findings, in need of future investigation.