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Abstract
Laryngeal cancer incidence has declined in the Western World, but subsite-specific trends are underreported. This study assessed changes in the profile of laryngeal cancer patients in a regional cancer network. Two patient cohorts from the west of Scotland were analysed: 326 patients diagnosed in 1999-2001 (historical cohort) and 386 diagnosed in 2018-2020 (contemporary cohort). Changes in risk factors, tumour characteristics, and treatment patterns were compared using Chi-square and Student's t-tests. Two-year survival was assessed using the Kaplan-Meier method and Cox proportional hazards models. Overall proportion of supraglottic (C32.1) cancers increased from 38.0 to 58.0%, becoming the predominant subtype, while glottic (C32.0) cancers decreased from 56.7 to 32.6% (p < 0.001). Early-stage diagnosis of glottic cancers rose from 65.6 to 77.0% (p = 0.031), while supraglottic cancers continued present at advanced stages, 70.5% vs. 64.3% (p = 0.24). Surgical treatment for all laryngeal cancers increased from 10.4 to 38.2%, while radiotherapy declined from 57.7 to 38.2% (p < 0.001). Two-year risk of death for glottic cancers decreased by 42% in the contemporary cohort (p = 0.02), with no significant survival change for supraglottic or overall laryngeal cancers. Glottic cancers now represent a smaller proportion of laryngeal cancer cases, with earlier diagnosis and improved survival outcomes. Conversely, supraglottic cancers have become more prevalent, often diagnosed at advanced stages without improvements in overall survival.
Published Version
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