Incidence Of Laryngeal Cancer Research Articles

Epidemiology of laryngeal carcinoma in Germany, 1998-2011.

Constituting 25-30% of all head and neck cancer cases, laryngeal carcinoma is the most prevalent entity. Major risk factors of laryngeal cancer are smoking and excessive alcohol consumption. This study presents the recent developments in the incidence of laryngeal cancer from 1998 to 2011 in Germany. Laryngeal carcinoma was identified using International Statistical Classification of Diseases and Related Health Problems (ICD10) from German population-based cancer registries. The incidence was provided by the Robert Koch Institute, and the mortality data were derived from German death statistics for further evaluation. Both descriptive and analytical analyses were conducted. From 1998 to 2011, a total of 14,847 laryngeal carcinoma cases were reported, in 13,195 men and 1652 women. Glottic carcinoma represented the main entity, constituting 69% of male cases and 50% of female cases. For men, a decline in incidence was observed starting in 2006. The incidence rate for women remained stable for the period of observation. The incidence of laryngeal cancer resembles the development of smoking behaviour in Germany. To maintain the positive trend of the male population and to reduce the incidence in women, it is crucial to continue and to improve the prevention of smoking campaigns in Germany.

Злокачественные новообразования верхних дыхательных путей у населения Томской области

Tomsk region refers to the areas of increased risk of malignancies, including laryngeal and upper respiratory tract cancers, which account for 2.0 % of all cancer cases. Approximately 83 new cancer cases (70 % in males) are annually diagnosed, with a tendency to increase. In 2014, the standardized incidence rate of upper respiratory tract cancer (URTC) was 7.7 per 100,000 men and women. The incidence rate was 6.7 times higher in men than in women. Laryngeal cancer was the most common malignancy in both men (67.7 %) and women (60.0 %). The age-standardized mortality rate of laryngeal cancer was 2.7 per 100,000 of population. Among patients registered at the end of 2014, 1.1 % patients were diagnosed with laryngeal cancer and 0.3 % with pharyngeal cancer. The laryngeal cancer incidence in the Tomsk region was lower than that in the Russian Federation as a whole. The rates of laryngeal and pharyngeal cancer detection at prophylactic medical examinations remain low (5.9 % and 1.5 %, respectively), and 1-year lethality rates are high (65.2 % and 28.6 %, respectively). Introduction of the program on pre-cancer and early laryngeal cancer detection into routine clinical practice allowed us to identify diagnostic errors in 16.3% of cases, verify laryngeal cancer and to form groups at high risk for laryngeal cancer in 20.6 % of cases.

Laryngeal biopsies: are we doing more, and why? A decade of results.

Over the last decade, we have observed an escalating trend in the number of laryngeal biopsies performed, despite the incidence of laryngeal cancer remaining constant. This study aimed to quantify the rate of laryngeal biopsies and record the indications. A retrospective analysis of laryngeal biopsies performed in North Glasgow, Scotland, UK, between 2001 and 2010, was conducted. From 2001 to 2010, 3902 laryngeal biopsies were carried out in North Glasgow. Histopathological results indicated the following diagnoses: squamous cell carcinoma, in 889 cases (23 per cent); dysplasia, in 986 cases (25 per cent); 'no tumour', in 913 cases (23 per cent); and benign pathology, in the remaining 1084 cases (28 per cent). There has been a significant increase in the number of biopsies performed after 2004, with the incidence of squamous cell carcinoma and benign disease remaining relatively static. It is hypothesised that organ preservation strategies, endoscopic resection in early stage laryngeal cancer and chemoradiotherapy in advanced head and neck cancer are responsible for the increase in laryngeal biopsies.

Epidemiological Study of Laryngeal Carcinoma in Western Nepal.

Laryngeal malignancy is a common malignancy of the head and neck region. Affected patients usually present with features that are characteristic of certain subsites. The larynx is oncologically divided into three: supraglottis, glottis and subglottis. Studies from Western countries have shown that the glottis is the commonest subsite to harbour laryngeal malignancy. However, the supraglottis has been reported to be the commonest subsite in developing countries, including examples in the Indian subcontinent. To our knowledge, no study has been carried out in western Nepal about the epidemiology of laryngeal cancer to date. The purpose of this study was to analyse the epidemiology of laryngeal cancer in relation to its risk factors, age distribution,and preferred subsites and to see if there is any recent change in the subsite wise distribution of laryngeal malignancy in western Nepal. Patients of all ages and both sexes with suspected laryngeal malignancy were enrolled in the initial study. Detailed history taking and clinical examination was performed to find out the involved subsite in relation to the clinical features. Direct laryngoscopy was performed to further confirm the subsite and to take biopsy from the growth under general anesthesia. After confirmation of malignancy from the biopsy report, patients were finally included in the study. Data were analysed and observations were made to find out the distribution of laryngeal malignancy in different subsites. The supraglottic larynx was the commonest subsite to harbor laryngeal malignancy. Smoking and alcohol were found to be the common risk factors. The mean age of the patients was in their sixties. Laryngeal malignancy is common in elderly individuals. Supraglottic laryngeal malignancy is the commonest laryngeal malignancy in people who smoke and drink alcohol in Nepal. Avoidance of alcohol use and smoking will be a milestone to reduce the incidence of laryngeal cancers and associated mortality.

Epidemiological review of laryngeal cancer: An Indian perspective.

Background:Laryngeal cancer is one of the 10 leading causes of cancer in Indian men. The association of laryngeal cancer and tobacco smoking is well-established, but the peculiarities such as wide variation of disease distribution and survival, role of tobacco chewing, indoor air pollution, and dietary factors in laryngeal cancer causation needs to be understood. In this study, we review the descriptive and observational epidemiology of laryngeal cancer in India.Materials and Methods:MEDLINE and Web of science electronic database was searched from January 1995 to December 2013, using the using keywords “laryngeal cancer, laryngeal cancer outcome, epidemiology, etiological factor and their corresponding Mesh terms were used in combination like OR, AND.” Two authors independently selected studies published in English and conducted in India. A total of 15 studies were found to be relevant and eligible for this review.Results:In India, laryngeal cancer contributes to approximately 3-6% of all cancers in men. The age-adjusted incidence rate of cancer larynx in males varies widely among registries, highest is 8.18 per 100,000 in Kamprup Urban District and the lowest is 1.26 per 100,000 in Nagaland. The 5-year survival for laryngeal cancer in India is approximately 28%. Indian studies show tobacco, alcohol, long-term exposure to indoor air pollution, spicy food, and nonvegetarian diet as risk factors for laryngeal cancer.Conclusion:There is wide regional variation in the incidence of laryngeal cancer in India. Survival rates of laryngeal carcinoma are much lower as compared to other Asian countries. Studies conducted in India to identify important risk factors of laryngeal cancer are very limited, especially on diet and indoor air pollution. Hence, more research is required for identifying the etiological factors and development of scientifically sound laryngeal cancer prevention programs.

Trends and regional variation in the incidence of head and neck cancers in England: 2002 to 2011.

Recent studies show an increased incidence of head and neck cancers worldwide. The present study evaluated the trend in the incidence of head and neck cancers in England during 2002-2011. Data were extracted from the database of Office for National Statistics. The study population was categorised according to age, residential area, gender and cancer sub-types. Overall trend in incidence of head and neck cancer and some subtypes were examined using Poisson regression models. In total, 71,457 head and neck cancers were registered in England between 2002 and 2011 and 68% of patients were males. Statistically significant increases in incidence of 27.0 and 32.4% were documented in males and females, respectively (p<0.001) with the largest increase in the 60+ age category. Potentially HPV-associated cancers, oral cavity cancers and laryngeal cancers increased by 47.1, 24.1 and 1.7% in males and 37.5, 25.5 and 7.7% in females, respectively (p<0.001). Regional differences were also noted with the highest incidence (18.0 and 17.0 per 100,000, respectively) in the North East and North West of England. Our results for England showed an increase in the incidence of both oral cavity and oropharyngeal cancer in both genders, whilst laryngeal cancer incidence remained stable.

Trends in Laryngeal Cancer Incidence in a Health Area Between 2007 and 2013

ObjectiveOur aim was to study the trend between 2007 and 2013 in the incidence of larynx cancer in a health district of 300,000 inhabitants. Material and methodWith information from the hospital cancer registry for the reference health area, we calculated the incidence and subsequently performed a joinpoint regression using specific software. ResultsWe found a statistically-significant downward trend with an annual percentage change of −10.83 LC 95% (−16.85, −4.40) between 2007 and 2013. ConclusionsWe found that the tendency of incidence in larynx cancer decreased, mainly in males, where the results were statistically significant. These results should encourage continuing prevention of smoking and alcohol consumption.

Incidence and mortality of laryngeal cancer in China, 2011.

Laryngeal cancer is the common cancer of the upper aerodigestive tract. We aimed to use the national cancer registration data in 2011 to estimate the incidence and mortality of laryngeal cancer within China. Comparable, high-quality data from 177 population-based cancer registries were qualified for analysis. The pooled data were stratified by area, sex and age group. National new cases and deaths of laryngeal cancer were estimated using age-specific rates and national population in 2010. All incidence and death rates were age-standardized to the 2000 Chinese standard population and Segi's population, which were expressed per 100,000 populations. All 177 cancer registries covered a total of 175,310,169 population (98,341,507 in urban and 76,968,662 in rural areas), accounting for 13.01% of the national population. The data quality indicators of proportion of morphological verification (MV%), percentage of cancer cases identified with death certification only (DCO%) and mortality to incidence ratio (M/I) were 77.98%, 2.62% and 0.55, respectively. Estimated 20,875 new cases of laryngeal cancer were diagnosed and 11,488 deaths from laryngeal cancer occurred in China in 2011. The crude incidence rate of laryngeal cancer was 1.55/100,000 (2.69/100,000 in males and 0.35/100,000 in females). Age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 1.13/100,000 and 1.14/100,000, respectively. Laryngeal cancer is much rarer in females than in males. The incidence rate was higher in urban areas than that in rural areas. The crude mortality rate of laryngeal cancer was 0.85/100,000 (1.42/100,000 in males and 0.25/100,000 in females). Age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were both 0.61/100,000. The mortality rate in males was much higher than that in females. There was no definite difference in mortality rates of laryngeal cancer between urban and rural areas. Larynx is a specialized area and cancer of larynx significantly affects the quality of life for the patients. Comprehensive measures should be carried out to prevent the ascent of laryngeal cancer.

Incidence and mortality of laryngeal cancer in Zhejiang cancer registry, 2000-2011.

Laryngeal cancer is the one of the most prevalent cancer of the upper respiratory tract. Aiming to get a better understanding of the epidemiological characteristics and trends of laryngeal cancer in Zhejiang cancer registry in China during 2000-2011, we used the standardized quality control and statistical methods to analyze the incidence and mortality that were vital for making decision about laryngeal cancer prevention and control. Comparably high-quality data from eight population-based cancer registries in Zhejiang from 2000 to 2011 were qualified for analysis. The pooled data were stratified by area, sex, and age group. All incidence and mortality rates were age-standardized to the 2000 Chinese standard population and Segi's population, which were expressed per 100,000 populations. Average annual percent changes (AAPCs) and 95% confidence intervals of laryngeal cancer incidence and mortality were calculated for the temporal trends. The logarithmic trend line was also drawn to reflect the time trends of incidence and mortality. During the 12 years, the 8 cancer registries covered a total of 81,758,277 person-year population (65,500,842 in urban and 16,257,435 in rural areas) including 41,315,911 person-year males and 40,442,366 person-year females. The age-standardized incidence rates were 1.10/10(5) by Chinese population and 1.12/10(5) by world population, respectively. The incidence of laryngeal cancer was relatively low in subjects under 44 years old. Then, it increased sharply after 45 years old and finally reached the peak in subjects of 75-79 years old. The age-standardized mortality rates of the Chinese population and world population were 0.28/10(5) and 0.35/10(5), respectively. The mortality of laryngeal cancer was at a low level in subjects under 49 years old. The rate dramatically increased in subjects over 50 years old, and then peaked in the age group of 80-84 years. The crude incidence of laryngeal cancer in Zhejiang cancer registration areas in 2000 was approximately 1.39/10(5), and it reached 1.78/10(5) in 2011, with the AAPC of 2.47%; the temporal trend line indicates that the incidence remained steady during the 12 years. The crude mortality of laryngeal cancer in Zhejiang registration areas in 2000 was about 0.30/10(5) and increased to 0.66/10(5), with the AAPC of 4.24% which showed no statistical significance; the temporal trend line indicates that mortality was going up to a certain extent, but not evident. Laryngeal cancer significantly influenced the quality of life for the patients. The comprehensive measures should be carried out to prevent the upward trend of laryngeal cancer.

Laryngeal cancer incidence and mortality in China, 2010.

To analyze the incidence and mortality of laryngeal cancer in cancer registration areas of China in 2010. Until June 1, 2013, 219 population-based cancer registries submitted data of 2010 to the National Central Cancer Registry of China covering about 207,229,403 population, and 120 cancer registries were selected after quality evaluation for this analysis. Laryngeal cancer cases were selected from the database according to International Classification of Diseases 10th Revision coded as "C32." We calculated the crude incidence and mortality rates of laryngeal cancer by sex, age, and location (urban/rural). The China population in 2000 and Segi's population were used as standardized populations for the calculation of age-standardized rates. In 2010, it was estimated that there were 20,272 new cases diagnosed as laryngeal cancer in China, including 17,703 males and 2569 females. The crude incidence rate of laryngeal cancer was 1.54/100,000 in 2010, accounting for 0.66% of overall new cancer cases. The age-standardized by China population (ASRcn) and by world population (ASRwld) were 1.18/100,000 and 1.20/100,000, respectively. Cumulative rate (0-74 years old) and truncated age-standardized rate (35-64 years old) were 0.15% and 1.98/100,000, respectively. Moreover, it was estimated that there were 11 914 cases died in laryngeal cancer in China, including 10,038 males and 1876 females. The crude mortality rate was 0.91/100,000, accounting for 0.61% of overall cancer deaths. The ASRcn and ASRwld were 0.68/100,000 and 0.69/100,000, respectively. Cumulative rate and truncated age-standardized rates were 0.08% and 0.88/100,000, respectively. Both incidence and mortality of laryngeal cancer in China were still low in 2010.

Association between CYP1B1 Gene Polymorphisms and Risk Factors and Susceptibility to Laryngeal Cancer

BackgroundThe aim of this study was to investigate the association between polymorphism of the cytochrome P450 1B1 (CYP1B1) gene, a metabolic enzyme gene, and the susceptibility to laryngeal cancer among the Chinese Han population.Material/MethodsIn a case-control study, we investigated polymorphisms in the CYP1B1 gene (rs10012, rs1056827, and rs1056836) with a real-time quantitative polymerase chain reaction (PCR) assay (TaqMan). The study was conducted with 300 Chinese Han patients with laryngeal cancer and 300 healthy Chinese Han subjects in a control group. We also studied the interactions between genetic polymorphism and risk factors such as smoking and alcohol consumption in the pathogenesis of laryngeal cancer.ResultsThere were statistically significant differences in the distributions of the rs1056827 and rs1056836 genotypes between the 2 groups. Regarding rs1056827, carriers of the T allele had a significantly higher risk of laryngeal cancer than the G-allele carriers (OR=1.4339, 95% CI: 1.1268–1.8247; P=0.0034). The difference was still statistically significant after adjusting for factors such as age, sex, smoking, and drinking (adjusted OR=1.743, 95% CI: 1.124–3.743, P<0.001). However, regarding rs1056836, the G allele carriers had a significantly lower risk of laryngeal cancer than the C allele carriers (OR=0.5557, 95% CI: 0.3787–0.8154; P=0.0027). The difference was statistically significant even after adjusting for factors such as age, sex, smoking, and drinking (adjusted OR=0.5641, 95% CI: 0.3212–0.8121, P=0.001). Subjects who carry the C-T-C haplotype have a significantly increased incidence of laryngeal cancer. We also found that CYP1B1 rs1056827 polymorphism had synergistic effects with smoking or alcohol consumption regarding the risk of laryngeal cancer.ConclusionsCYP1B1 gene polymorphism is closely related to the onset of laryngeal cancer. There is a mutually synergistic effect between smoking, alcohol consumption, and CYP1B1 gene polymorphisms regarding laryngeal cancer.

As Campanhas da Voz no percurso da Informação, Educação e Comunicação em Saúde – uma (re)visão reflexiva.

A Campanha da Voz proposta pela Sociedade Brasileira de Fonoaudiologia (SBFa) é uma ação estratégica em Saúde que tem como objetivo promover os cuidados com a voz junto à população. Surgiu com um enfoque na prevenção, a partir do aumento da incidência de câncer de laringe na população brasileira, sendo que atualmente aborda diversos temas e estratégias na busca pela Promoção da Saúde, representando, portanto uma importante ação educativa promovida no âmbito da Fonoaudiologia e da Saúde Coletiva, e que embora muito valorizada pelos fonoaudiólogos, ainda tem sido pouco estudada. Neste sentido, este artigo tem como objetivo realizar uma revisão crítica reflexiva sobre as campanhas da voz promovidas pela Sociedade Brasileira de Fonoaudiologia (SBFa) no contexto da Informação, Educação e Comunicação em Saúde. Entender os reflexos da campanha está relacionado à possibilidade de modificação das estratégias pedagógicas utilizadas, sustentada pela instrumentalização teórica estabelecida. Isso demonstra a necessidade de uma maior instrumentalização por parte dos profissionais envolvidos neste processo para que possa garantir a qualidade da proposta de uma campanha em saúde. Neste sentido a revisão dos conceitos trabalhados e a forma como são colocados à população nos direciona ao real objetivo das campanhas de saúde, ligado à promoção da saúde, refletindo na qualidade de vida da população.

Tendencia de la incidencia del cáncer de laringe en un área sanitaria, entre los años 2007 y 2013

ObjectiveOur aim was to study the trend between 2007 and 2013 in the incidence of larynx cancer in a health district of 300,000 inhabitants.Material and method With information from the hospital cancer registry for the reference health area, we calculated the incidence and subsequently performed a joinpoint regression using specific software. ResultsWe found a statistically-significant downward trend with an annual percentage change of -10.83 LC 95% (-16.85, -4.40) between 2007 and 2013. ConclusionsWe found that the tendency of incidence in larynx cancer decreased, mainly in males, where the results were statistically significant. These results should encourage continuing prevention of smoking and alcohol consumption.

Attributable fraction of alcohol consumption on cancer using population-based nationwide cancer incidence and mortality data in the Republic of Korea.

BackgroundIn the Republic of Korea, cancer is the most common cause of death, and cancer incidence and mortality rates are the highest in East Asia. As alcoholic beverages are carcinogenic to humans, we estimated the burden of cancer related to alcohol consumption in the Korean population.MethodsThe cancer sites studied were those for which there is convincing evidence of a positive association with alcohol consumption: oral cavity, pharynx, esophagus, colon, rectum, liver, larynx and female breast. Sex- and cancer-specific population attributable fractions (PAF) were calculated based on: 1) the prevalence of alcohol drinkers among adults ≥20 years of age in 1989; 2) the average daily alcohol consumption (g/day) among drinkers in 1998; 3) relative risk (RR) estimates for the association between alcohol consumption and site-specific cancer incidence obtained either from a large Korean cohort study or, when more than one Korean study was available for a specific cancer site, meta-analyses were performed and the resulting meta-RRs were used; 4) national cancer incidence and mortality data from 2009.ResultsAmong men, 3% (2,866 cases) of incident cancer cases and 2.8% (1,234 deaths) of cancer deaths were attributable to alcohol consumption. Among women, 0.5% (464 cancer cases) of incident cancers and 0.1% (32 deaths) of cancer deaths were attributable to alcohol consumption. In particular, the PAF for alcohol consumption in relation to oral cavity cancer incidence among Korean men was 29.3%, and the PAFs for pharyngeal and laryngeal cancer incidence were 43.3% and 25.8%, respectively. Among Korean women, the PAF for colorectal cancer incidence was the highest (4.2%) and that for breast cancer incidence was only 0.2%. Avoiding alcohol consumption, or reducing it from the median of the highest 4th quartile of consumption (56.0 g/day for men, 28.0 g/day for women) to the median of the lowest quartile (2.80 g/day for men, 0.80 g/day for women), would reduce the burden of alcohol-related cancers in Korea.ConclusionsA reduction in alcohol consumption would decrease the cancer burden and a significant impact is anticipated specifically for the cancers oral cavity, pharynx, and larynx among men in the Republic of Korea.

Squamous cell carcinoma of larynx in an 8‐year‐old child: Successful management with chemo‐radiation

Incidence of laryngeal squamous cell cancer (SCC) in childhood is rare, more so in children below 10 years of age. Due to the rarity of the disease and nonspecific symptoms diagnosis often gets delayed. Treatment is challenging and demands expert multi-modality care. We describe the clinico-pathologic findings and management of laryngeal cancer with chemo-radiation in an 8-year-old male. After 18 months of completion of treatment the child is in complete remission clinically and radiologically. This report aims at increasing awareness of head and neck SCC in paediatric population and also underscores the importance of multi-modality care in managing such cases.

Tea intake and risk of oral, pharyngeal, and laryngeal carcinoma: a meta-analysis.

BackgroundThe association between tea intake and risk of oral, pharyngeal, and laryngeal carcinoma is still unclear. The aim of this meta-analysis was to quantify the effect of tea consumption on the incidence of oral, pharyngeal, and laryngeal cancer to provide a better understanding on this issue.Material/MethodsA literature search was conducted before January 2014 in MEDLINE and EMBASE databases. The relative risk (RR) estimates that extracted or calculated from all included studies were combined together. Given the existing heterogeneity in the study design and data source, a random-effects model was obtained.ResultsA total of 20 articles were included in the quantitative synthesis. Fourteen RR estimates (11 from case-control studies and 3 from cohort studies) were pooled together and the result demonstrated that tea consumption reduced the incidence of oral cancer (RR=0.85; 95% CI 0.76–0.96). The summary RR of 4 observational studies (3 case-control studies and 1 cohort study) for pharyngeal cancer was 0.87 (95% CI 0.74–1.04). The association between tea consumption and oral and pharyngeal carcinoma was reported. The summary RR for laryngeal carcinoma was 1.05 (95% CI 0.70–1.57). The Begg’s funnel plot and the Egger’s test showed no evidence of publication bias.ConclusionsTea consumption was associated with decreased risk of oral cancer, while no association was detected with oral/pharyngeal, pharyngeal, or laryngeal cancer.

Incidence and mortality of larynx cancer in China during 2003-2007

To analyze the patterns of incidence and mortality on larynx cancer in China. Data from 32 Cancer Registries in China were examined, sorted, and analyzed by the National Cancer Registry, to obtain the crude, Chinese national and world age-standardized rates (ASR) of incidence and mortality and their trends. The crude incidence and mortality rates of larynx cancer were 2.04/10(5) and 1.06/10(5) in China during 2003-2007. The rates were higher in males than those in females, and also higher in urban areas than those in rural areas. The highest Chinese ASRs of incidence and mortality of larynx cancer in 32 cancer registries in China were 2.08/10(5) in Zhongshan city, Guangdong province, and 1.58/10(5) in She county, Hebei province respectively. The trend of incidence and mortality of larynx cancer was stable from 2003 to 2007. Although both the incidence and mortality of larynx cancer in China were still in low level, comprehensive measures should be carried out to prevent the increase on both the incidence and mortality of larynx cancer.

Trends in Total Laryngectomy in the Era of Organ Preservation

To describe time trends in total laryngectomy health services utilization across the United States, such as rates of surgery, cost, length of stay, and insurance payer, and to compare this to important milestones in recommendations for laryngeal cancer treatment. Population-based cohort study. Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) 1997-2008: stratified sample of all US hospital discharges. All patients with the principal procedure of complete laryngectomy. The unit of analysis was the discharge. Between 1997 and 2008, the number of laryngectomies done in the United States decreased by 48%. New cases of laryngeal cancer decreased 33% during the same time. The proportion of patients older than 65 years decreased from 48% to 43%. Mortality for the procedure was 1.4% in 1997 and 1.1% in 2008. Mean length of stay over the study period increased from 13 days to 14 days. Mean hospital charges rose from $58,000 in 1997 to $109,000 in 2008, consistent with the overall rise in US health care costs. Medicare was the dominant insurer throughout. Home health was ordered in 50% of 2008 discharges but only 32% in 1997. The rate of total laryngectomy has dropped more than the incidence of laryngeal cancer has dropped, consistent with the trend toward nonsurgical treatment. Lower surgical volumes and/or salvage laryngectomy surgeries are hypothesized to play a role in longer length of stay, stable mortality rates despite younger patient age, and increased need for home services after discharge.

Are laryngeal squamous cell carcinoma incidence and patient mortality a function of ABO blood grouping? A retrospective study

Few studies have examined the association between ABO blood grouping and head and neck cancer. This retrospective review examined the association between blood group and laryngeal cancer incidence and patient mortality. Of 271 patients treated for squamous cell laryngeal carcinoma (1997-2002), 143 patients with supraglottic, glottic and subglottic tumours were included; 128 patients were excluded. The blood group characteristics of patients and healthy blood donors were compared. There was no significant correlation between blood type and laryngeal carcinoma incidence or mortality. Type A blood was commoner in African Americans with laryngeal cancer than Caucasian patients, but not significantly so. As expected, five-year survival rates were lower in patients with more advanced stage cancer (p < 0.0001). Although our findings show no association between blood group and five-year survival, these results are inconclusive, and warrant further study of the association between blood type and laryngeal (and other) head and neck cancers.

Trends in Total Laryngectomy: A Population Based Study

Objective: 1) Understand time trends in total laryngectomy rates across the US, including rates of surgery, cost, length of stay, teaching status, size of hospital, and insurance payer. 2) Understand what role the paradigm shift in primary treatment of laryngeal cancer may mean for surgical outcomes, cost, and length of stay. Method: Population-based study from 1997 to 2008 utilizing the HCUP-NIS database: a stratified sample of all US hospital discharges. The sample was all patients who had a principal procedure of ICD-9 code 30.3 or 30.4 (complete or radical laryngectomy). The unit of analysis was census area: Northeast, South, Midwest, and West. Results: The number of laryngectomies done in the US decreased by 32% during the study period. New cases of laryngeal cancer decreased 26% during the same time. The highest rate of laryngectomy is in the South, the lowest in the Midwest and West. Mortality for the procedure is highest in the Northeast: 2.1%. Mean length of stay over the study period increased from 12.7 days to 13.9 days. Length of stay is shortest in the South. Median hospital charges rose dramatically (in 2008 dollars), from $34,934 in 1997 to $61,507 in 2008. Medicare remains the dominant insurance source. Conclusion: The rate of total laryngectomy has dropped more than the incidence of laryngeal cancer has dropped—suggesting that larynx preservation treatment has become dominant. Some implications of this shift are previously unexplored. As the number of procedures drops, the utility of a detailed registry to track outcomes becomes even greater.