Oropharyngeal Cancer Incidence Rates Research Articles

Factors associated with the decreasing rate of oropharyngeal cancer in young adults in the United States.

10534 Background: To evaluate trends of HPV-associated oropharyngeal cancers and HPV infections in the United States. Methods: Data was extracted from the United States Cancer Statistics Public Use Database (USCS) between 2001 and 2017 and the National Health and Nutrition Examination Survey (NHANES) between 2011 to 2016. Data on oropharyngeal squamous cell carcinoma (OSCC) was obtained from the USCS database. HPV vaccination and screening (oral washings) data were obtained from NHANES. Based on CDC guidelines, HPV strains were further subdivided into high-risk strains (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68). Results: Based on USCS, oropharyngeal cancer incidence rates have increased in males by 1.64% every year (p < 0.001) while remaining stable in females over the last 17 years. Oropharyngeal cancers have increased for all age groups over the age of 55, with the largest increase seen in those between the ages of 65-69 years old (p < 0.001). However, individuals between the ages of 30-34 had the largest decrease in oropharyngeal cancers over the same time period (p = 0.016). Based on race, Whites had the highest incidence rates at 5.12/100,000 followed by 2.99 in Blacks, 2.32 in Hispanics, and 1.11 in Asians. By geographical region, the incidence was found to be the highest in the Midwest with 4.68/100,000 and the lowest in the West at 3.78. Our intersectional analysis showed that White males in the South aged 65-69 had the highest incidence of oropharyngeal cancers at 40.57/100,000 and this same group aged 60-64 had the highest annual increase at 4.65% (p < 0.001). Using the NHANES database, we showed that those with greater than 4 lifetime sexual partners have a 3-fold higher risk of high risk HPV infection compared to those with 4 or under (7.1% vs 1.9%, p < 0.0001). 8.8% of current smokers are infected with high risk oral HPV compared to only 3.9% of non smokers (p < 0.001). The incidence of any HPV infection for those <39 years old was 5.9% in 2011 and 4.7% in 2016 (p = 0.4723). In contrast, the incidence in those > 39 years old was 6.6% in 2011 and 6.4% in 2016 (p = 0.99). On multivariate analysis, males have a 4-fold higher risk of high risk HPV infections compared to females (4.45, 95% CI: 2.94 - 6.74, p < 0.0001). Those with five or more sexual partners have 7-fold higher rate of high risk oral HPV infections compared to those without any sexual partners (7.15, 95% CI: 1.94 - 26.3, p = 0.0039). Furthermore, current smokers (1.81, 95% CI: 1.17 - 2.77, p = 0.0081) and three to four drinks per day (1.63, 95% CI: 1.05 - 2.55, p = 0.0312) have an increased risk of high risk oral HPV infections. Conclusions: Over the last 18 years, oropharyngeal cancers are increasing in individuals over the age of 55, particularly White males residing in the South. Individuals with greater than 4 lifetime sexual partners, current smokers, and those who consume three to four drinks per day have increased HPV infectivity rates.

POSC183 Epidemiological Disease Burden of Malignant Neoplasm of Oropharynx Based on Routinely Collected Health Insurance Claims Data

The incidence rates for oropharyngeal cancers have been increasing during recent decades, predominantly in developed countries. Worldwide tobacco and alcohol use remains the most important risk factors for oropharyngeal cancer. The aim of our study was to determine the epidemiological disease burden of malignant neoplasm of oropharynx.

Worldwide trend in human papillomavirus-attributable cancer incidence rates between 1990 and 2012 and Bayesian projection to 2030.

There is a paucity of global comparative trend analyses of all human papillomavirus (HPV)-attributable cancers. In addition, most analyses by international sources only describe past trends; few studies have projected the future trend of HPV-attributable cancers. Data were used from the Cancer Incidence in Five Continents (CI5plus) database that contains annual incidence by cancer site, age, and sex, as well as corresponding populations. Age-standardized HPV-attributable cancer incidence rates were calculated and plotted from 1990 through 2012. A Bayesian age-period-cohort model was used to project the HPV-attributable cancer incidence rates of each country up to 2030. A significant but small decreasing trend worldwide in the HPV-attributable cancer incidence rate was observed with an average annual percent change (AAPC) of -0.3 (95% CI, -0.6 to -0.1). Notably, Uganda had a consistently increasing trend of HPV-attributable cancer incidence rate, with an AAPC of 1.7 (95% CI, 0.6-2.9). U-shaped trends were observed in some high-income countries because of a recent increase in oral cavity and oropharyngeal cancers. Most countries experience a decreasing or stable trend in HPV-attributable cancers incidence rates between 1990 and 2030. However, Japan, the United Kingdom, the Netherlands, Italy, Costa Rica, and Uganda will have an increasing trend during the projection period. Analyses revealed favorable downward trends in HPV-attributable cancer incidence rates in most of the included countries. However, the persistently increasing trend in HPV-attributable cancer incidence rates in Uganda and the recent increase in oral cavity and oropharyngeal cancer incidence rates in some high-income countries may present a new challenge for global HPV-attributable cancer prevention. Analyses revealed favorable downward trends in human papillomavirus (HPV)-attributable cancer incidence rates in most of the included countries. However, the persistently increasing trend in HPV-attributable cancer incidence rates in Uganda and the recent increase in oral cavity and oropharyngeal cancer incidence rates in some high-income countries may present a new challenge for global HPV-attributable cancer prevention.

Incidence rates of oral cavity and oropharyngeal cancers among men: a comparison of active-duty military and general populations.

This study compared oral cavity and oropharyngeal cancer incidence rates and trends among men in the active-duty military and the general population of the USA. Data were from the Department of Defenses' Automated Central Tumor Registry (ACTUR) and the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER-9) registries. Age-adjusted oral cavity and oropharyngeal cancer incidence rates among men aged 20-59 from 1990-2013 were compared between ACTUR and SEER populations. The age-adjusted oral cancer incidence rate was lower in ACTUR than SEER (IRR = 0.89, 95% confidence interval (CI), 0.81-0.98). Incidence was lower in ACTUR for oral cavity cancer (IRR = 0.75, 95% CI, 0.66-0.89) and remained lower when stratified by age and race. ACTUR oropharyngeal cancer rates were higher than SEER among Whites (IRR = 1.19, 95% CI, 1.01-1.39) and men aged 40-59 (IRR = 1.18, 95% CI, 1.00-1.39). Oropharyngeal cancer increased for both populations over time, whereas oral cavity cancer increased in ACTUR but decreased in SEER. Rates were lower in ACTUR than SEER for oral cavity, but not for oropharyngeal cancer. Temporal oral cancer incidence patterns differed between the two populations. This study provides clues for more research on possible variations between these two populations and related factors.

An economic and disease transmission model of human papillomavirus and oropharyngeal cancer in Texas

In 2017, 46,157 and 3,127 new oropharyngeal cancer (OPC) cases were reported in the U.S. and Texas, respectively. About 70% of OPC were attributed to human papillomavirus (HPV). However, only 51% of U.S. and 43.5% of Texas adolescents have completed the HPV vaccine series. Therefore, modeling the demographic dynamics and transmission of HPV and OPC progression is needed for accurate estimation of the economic and epidemiological impacts of HPV vaccine in a geographic area. An age-structured population dynamic model was developed for the U.S. state of Texas. With Texas-specific model parameters calibrated, this model described the dynamics of HPV-associated OPC in Texas. Parameters for the Year 2010 were used as the initial values, and the prediction for Year 2012 was compared with the real age-specific incidence rates in 23 age groups for model validation. The validated model was applied to predict 100-year age-adjusted incidence rates. The public health benefits of HPV vaccine uptake were evaluated by computer simulation. Compared with current vaccination program, increasing vaccine uptake rates by 50% would decrease the cumulative cases by 4403, within 100 years. The incremental cost-effectiveness ratio of this strategy was $94,518 per quality-adjusted life year (QALY) gained. Increasing the vaccine uptake rate by 50% can: (i) reduce the incidence rates of OPC among both males and females; (ii) improve the quality-adjusted life years for both males and females; (iii) be cost-effective and has the potential to provide tremendous public health benefits in Texas.

The incidence of oropharyngeal cancer and rate of human papillomavirus vaccination coverage in Florida, 2011 through 2015

ObjectivesThe authors aimed to compare the incidence of oropharyngeal cancer (OPC) from 2011 through 2015 and the rate of human papilloma virus (HPV) vaccination from 2015 through 2017 in the United States overall and in Florida. MethodsUsing SEER*Stat software (Surveillance Research Program, National Cancer Institute), the authors calculated age-specific OPC incidence rates for various age groups and age-adjusted rates by sex and race to analyze Surveillance, Epidemiology, and End Results program and National Program of Cancer Registries data. The authors used Joinpoint software (Surveillance Research Program, National Cancer Institute) to model time trends of OPC incidence. They estimated the rate of HPV vaccination among teenagers in Florida and explored the main reasons parents gave for not getting their children vaccinated by means of analyzing data from the National Immunization Survey-Teen. The authors used the χ2 test to determine the association between sociodemographic factors and HPV vaccination and to compare the rate of HPV vaccination in the United States overall with that in Florida. ResultsThe incidence of OPC was higher and the rate of HPV vaccination was lower in Florida than in the United States overall. The OPC incidence rate was highest in those who were aged 50 through 70 years, non-Hispanic white, and male. The rate of being up-to-date on HPV vaccination in Florida was higher among female teenagers than male teenagers but did not differ significantly by other sociodemographic characteristics. The top reason for not getting an HPV vaccination in Florida was that it had not been recommended. ConclusionsThe authors found relatively higher and increasing incidence rate of OPC in Florida and lower rate of HPV vaccination among adolescents in Florida than in the nation overall. Practical ImplicationsThe trends illustrated may stimulate policy changes to increase HPV vaccination for children and enhance the understanding of its benefits.

Increasing Incidence rates of Oropharyngeal Squamous Cell Carcinoma in Germany and Significance of Disease Burden Attributed to Human Papillomavirus.

Increasing incidences of head and neck cancers and rising proportions of these associated with human papillomavirus (HPV), especially in the oropharynx, have been reported in international studies. So far, the trends and contribution of HPV to the number of newly diagnosed cases of oropharyngeal squamous cell carcinomas (OPSCC) in Germany are uncertain. We investigated HPV association and incidence rates in a cohort of consecutively included patients with OPSCC in Giessen 2000-2017, and compared our results with regional (Giessen and the federal state of Hesse), national (Germany), and international (United States) databases. Regional data show a significant increase in the overall incidence rates of oropharyngeal cancers and in the incidence of HPV-associated cancers of the subsites tonsils and oropharynx, whereas other oropharyngeal subsites show no significant change. Analysis of national databases shows a significant incidence increase in Germany and in the United States. The rise in incidence is predominantly attributable to male patients in the US population, whereas in Germany rising OPSCC incidence is more associated with females. There is a significant elevation of OPSCC incidence rates in Germany, which corresponds to the recognized incidence increase of HPV-related oropharyngeal cancers based on experimental data from consecutively included patients of our cohort. Our investigation shows different patterns of this increase in Germany and in the United States, which demonstrates spatial heterogeneity and the need for population-based investigations regarding the role of HPV in oropharyngeal cancer.

Trends of two HPV-associated cancers in Massachusetts: cervical and oropharyngeal cancer.

To understand trends in the incidence and mortality of two human papillomavirus (HPV)-associated cancers, cervical and oropharyngeal cancer, in Massachusetts. From 2004 to 2014, the Massachusetts Cancer Registry recorded 3,996 incident cases of oropharyngeal cancer and 2,193 incident cases of cervical cancer. Mortality data were obtained from the Massachusetts Registry of Vital Records and Statistics from 2008 to 2014. Rates were age-standardized to the 2000 U.S. population and trends were assessed using joinpoint regression. While the incidence rate of cervical cancer (5.46 per 100,000) decreased by 2.41% annually (p = 0.004), the incidence rate of oropharyngeal cancer among males (7.85 per 100,000) increased by 2.82% annually (p = 0.0002). Mortality rates for both cancers decreased from 2008 to 2014 but were not statistically significant (cervical - 3.73% annually, p = 0.29; oropharyngeal - 1.94% annually, p = 0.44). The rising incidence rate of oropharyngeal cancer in men and the decreasing, but relatively high, incidence rate of cervical cancer in women highlight the need for further screening and prevention by HPV vaccination in Massachusetts.

CANCER EPIDEMIOLOGY IN THE TOMSK REGION

The present study was undertaken to evaluate the incidence of pharyngeal cancer in the Tomsk region for the period between 2007 and 2015. Approximately 27 new cases of pharyngeal cancer are annually diagnosed in the region. Between 2007 and 2015, the pharyngeal cancer incidence in males was reported to be higher (80.9 %) than in females. The incidence rate of oropharyngeal cancer was 73.4 %. This incidence rate was not stable over time, and it was 2.2 per 100,000 population in 2015. In 2015, the pharyngeal cancer incidence in the Tomsk region was the highest in the Siberian Federal District (2.3 compared to 0.4) The pharyngeal cancer incidence was higher in rural than urban areas. High percentage of patients with advanced-stage disease and one-year mortality was registered in the region.

Incidence trends in head and neck cancers and human papillomavirus (HPV)-associated oropharyngeal cancer in Canada, 1992–2009

Recently, human papillomavirus (HPV) infection has been causally associated with a subset of head and neck cancers, particularly oropharyngeal cancer. As national cancer reporting systems typically report incidence rates of oropharyngeal cancer grouped with other cancers of the head and neck region, the objective of this study was to present age-standardized incidence trends in oropharyngeal cancer Canada-wide. Data were obtained from the Canadian Cancer Registry for cases diagnosed between 1992 and 2009. Trends in age-standardized incidence rates were described for head and neck cancers overall and for HPV-associated oropharyngeal cancer using Joinpoint regression. The age-standardized incidence of head and neck cancers declined significantly in Canada from 1992 to 1998 (annual percentage change [APC]=-3.0, p<0.01), then remained stable through to 2009. In contrast, the age-standardized incidence of HPV-associated oropharyngeal cancer increased significantly during the same time period, from 1.6 per 100,000 in 1992 to 2.6 in 2009 (APC=2.7, p<0.001). The increase in HPV-associated oropharyngeal cancer was greater in males than in females and increased significantly in all age groups, particularly those aged 50-59 (APC=5.4, p<0.001). The age-standardized incidence rate of head and neck cancer overall was stable or declined in all age groups except those aged 50-59 where incidence decreased from 1992 to 1997, then increased through to 2009. The incidence patterns of HPV-associated oropharyngeal cancer and head and neck cancer overall show contrasting trends. Findings highlight the need to surveil HPV-associated oropharyngeal cancer separately from other cancers of the head and neck region in order to monitor these emerging trends.

Oropharyngeal cancer incidence and mortality in Scotland: are rates still increasing?

Oropharyngeal cancer incidence and mortality rates increased in Scotland between the early seventies and late eighties. Although these increases appeared to be cohort based, they were at that time confined to younger age groups. The aim of this study was to examine recent time trends in the incidence and mortality of oropharyngeal cancers in Scotland to determine whether previous increases in incidence and mortality had continued. Oropharyngeal cancer mortality rates in Scotland between 1950 and 1998 were analysed using data from the World Health Organisation Mortality Database. Incidence trends were analysed using cancer registration data for Scotland for the period 1965–1997. Between 1989 and 1996, incidence rates for oropharyngeal cancers have risen dramatically in males (18–23.6 per 100,000) and females (7.3–8.5 per 100,000) aged 35–64 years, while age-standardised mortality rates appear to have stabilised. Although oropharyngeal cancer incidence rates continue to rise alarmingly, these increases are not necessarily translated into higher mortality rates as had been suggested by results from earlier studies.