Pharyngeal Cancer Mortality Research Articles

Negative excess oral and pharyngeal cancer mortality in Europe during the early pandemic years

AbstractObjectiveThe COVID‐19 pandemic had direct and indirect effects on oral and pharyngeal cancer (OPC) mortality due to high COVID‐19 mortality risk among cancer patients, and to the COVID‐19 response that caused treatment delays and reduced routine visits. This study investigated the excess OPC mortality in Europe during the early pandemic years.MethodsMortality and population data were gathered from the Eurostat database. The 2011–2019 mortality rates were used to estimate the 2020–2021 expected rates through joinpoint trend analysis. The excess mortality rates (observed minus expected mortality) with 95% confidence intervals (95 CIs) were assessed.ResultsStatistically significant negative excess age‐standardized and crude (age strata <65 and ≥65 years) OPC mortality rates in males and females, in the European Union (EU, 27 countries) and Europe were reported. The estimated OPC missing deaths in EU were 831 (95 CI, 630–985) and 1240 (95 CI, 1039–1394) in 2020 and 2021, respectively, with differences between sexes, age strata, and countries. The OPC deaths in the EU and Europe were 3.6% and 3.5% lower than expected.ConclusionMissing OPC deaths reported in Europe in 2020–2021 could be explained by changes in death certification of OPC patients who developed COVID‐19, rather than a real OPC mortality decline.

Trends in lip, oral cavity, and pharyngeal cancer mortality in the United States, 1999–2019

Changes in the epidemiology of lip, oral cavity, and pharyngeal (LOCP) cancers have been reported in the United States. This study aimed to examine recent trends in LOCP cancer mortality in the United States from 1999 to 2019. National mortality data were extracted from CDC WONDER, 1999-2019. International Classification of Diseases Codes, 10th Revision-C00-C14, were used to identify decedents of malignant neoplasms of the lip, oral cavity, and pharynx. LOCP cancer mortality trends were assessed by fitting a Joinpoint regression model overall, and by race/ethnicity, sex, age, and US Census Region. Annual Percentage Changes (APC) were derived to estimate variations in mortality trends over time. The age-adjusted mortality rate (AAMR) for LOCP cancers was 2.5 per 100 000 (95% CI: 2.5-2.5), equivalent to 180 532 deaths during 1999-2019. Overall mortality trends have stabilized since 2009 (APC=0.3; 95% CI: -0.1, 0.7), but an examination by subtype revealed rising mortality trends from cancers of the lip and oral cavity (APC=1.2; 95% CI: 0.7, 1.6) and pharynx (APC=3.2; 95% CI: 1.7, 4.8), and declining trends in malignancies of other and ill-defined areas of the lip, oral cavity, and pharynx (APC=-2.7; 95% CI: -3.4, -2.0). Trend variations were also noted by sex, age, US Census Region, and race/ethnicity. There are differential trends in mortality from LOCP cancers in the United States. Investigating the biological, individual, and contextual factors related to LOCP cancers would guide effective public health intervention efforts.

Analysis of main statistical indicators of oral and pharyngeal cancer in the Republic of Uzbekistan

Relevance: According to GLOBOCAN data for 2020, oral and pharyngeal cancer ranked 25th in mortality (98 412 cases, 0.5% of all cancer deaths) and 26th in the number of diagnosed new cases (48 143 cases, 0.5% of all new cancer cases) in the world. Oral and pharyngeal cancer
 incidence is growing steadily globally and in the Republic of Uzbekistan. Oral and pharyngeal cancer ranks 16th in the structure of cancer incidence in the Republic of Uzbekistan, with a rate of 1.8 per 100 000 people.
 The purpose of the study was to analyze the main statistical indicators for tumors of the oral cavity and pharynx in the Republic of Uzbekistan in 2015-2021.
 Methods: We analyzed the main statistical indicators for tumors of the oral cavity and pharynx in the Republic of Uzbekistan for 2015-2020 obtained from the Reporting Form #7 “Information about malignant neoplasms cases.”
 Results: Over the past six years, the incidence rate per 100,000 people has increased from 1.4 in 2015 to 1.8 in 2020. In 2015-2020, in the Republic of Uzbekistan, 2,240 patients died from malignant neoplasms of the oral cavity and pharynx. The mortality rate per 100,000 people
 decreased from 1.4 in 2015 to 1.2 in 2020.
 Conclusions: Tumors of the oral cavity and pharynx rank 16th in the structure of cancer incidence in the Republic of Uzbekistan and tend to grow. A recent increase in oral and pharyngeal cancer incidence and its late detection could be explained by worsening detection and diagnostics. The stabilization of oral and pharyngeal cancer mortality results in socio-economic losses for the Republic. The provided statistical data is the basis for improving the indicators of incidence and mortality related to oral and pharyngeal cancer in the Republic of Uzbekistan

Analysis of main statistical indicators of oral and pharyngeal cancer in the Republic of Uzbekistan

Relevance: According to GLOBOCAN data for 2020, oral and pharyngeal cancer ranked 25th in mortality (98 412 cases, 0.5% of all cancer
 deaths) and 26th in the number of diagnosed new cases (48 143 cases, 0.5% of all new cancer cases) in the world. Oral and pharyngeal cancer
 incidence is growing steadily globally and in the Republic of Uzbekistan. Oral and pharyngeal cancer ranks 16th in the structure of cancer
 incidence in the Republic of Uzbekistan, with a rate of 1.8 per 100 000 people.
 The purpose of the study was to analyze the main statistical indicators for tumors of the oral cavity and pharynx in the Republic of Uzbekistan in 2015-2021.
 Methods: We analyzed the main statistical indicators for tumors of the oral cavity and pharynx in the Republic of Uzbekistan for 2015-
 2020 obtained from the Reporting Form #7 “Information about malignant neoplasms cases.”
 Results: Over the past six years, the incidence rate per 100,000 people has increased from 1.4 in 2015 to 1.8 in 2020. In 2015-2020, in the
 Republic of Uzbekistan, 2,240 patients died from malignant neoplasms of the oral cavity and pharynx. The mortality rate per 100,000 people
 decreased from 1.4 in 2015 to 1.2 in 2020.
 Conclusions: Tumors of the oral cavity and pharynx rank 16th in the structure of cancer incidence in the Republic of Uzbekistan and tend
 to grow. A recent increase in oral and pharyngeal cancer incidence and its late detection could be explained by worsening detection and diagnostics. The stabilization of oral and pharyngeal cancer mortality results in socio-economic losses for the Republic. The provided statistical
 data is the basis for improving the indicators of incidence and mortality related to oral and pharyngeal cancer in the Republic of Uzbekistan

Global trends in oral and pharyngeal cancer incidence and mortality.

To provide an up-to-date overview of recent trends in mortality from oral and pharyngeal cancer, we analyzed death certification data for 61 countries worldwide provided by the World Health Organization in 2010-2015, and, for selected most populous countries, over the period 1970-2016. For 12 largest countries, we analyzed incidence derived from Cancer Incidence in Five Continents in 1960-2012 for all oral and pharyngeal cancers and by subsites. In 2015, male age-standardized (world population) death rates per 100,000 were 5.03 in the European Union (EU), 8.33 in the Russian Federation, 2.53 in the United States (USA), and 3.04 in Japan; corresponding rates in women were 1.23, 1.23, 0.82, and 0.76. Male mortality decreased over the last decades in several European countries, with earlier and sharper declines in southern Europe; conversely, mortality was still increasing in a few eastern European countries and the United Kingdom. Mortality in men also decreased in Argentina, Australia, and Hong Kong, while it leveled off over more recent calendar years in Brazil, Japan, Mexico, the Republic of Korea, as well as in Australia and the USA. Female mortality slightly rose in various European countries. Overall incidence trends in the largest countries were broadly consistent with mortality ones, but oropharyngeal cancer incidence rose in many countries. Changes in tobacco and alcohol exposure in men over the last decades likely explain the favorable trends in oral and pharyngeal cancer mortality and incidence observed in selected countries worldwide, while increased human papillomavirus infection is likely responsible for the rise in oropharyngeal cancer incidence.

Trend of oral and pharyngeal cancer mortality in Brazil in the period of 2002 to 2013.

ABSTRACTOBJECTIVETo analyze the trend of oral and pharyngeal cancer mortality rates in the period of 2002 to 2013 in Brazil according to sex, anatomical site, and macroregion of the country.METHODSThe mortality data were obtained from the Mortality Information System and the population data were obtained from the Brazilian Institute of Geography and Statistics. The trend of the rates standardized by sex and age was calculated using the Prais-Winsten estimation, and we obtained the annual percentage change and the respective 95% confidence intervals, analyzed according to sex, macroregion, and anatomical site.RESULTSThe average coefficient of oral cancer mortality was 1.87 per 100,000 inhabitants and it remained stable during the study period. The coefficient of pharyngeal cancer mortality was 2.04 per 100,000 inhabitants and it presented an annual percentage change of -2.6%. Approximately eight in every 10 deaths occurred among men. There was an increase in the rates of oral cancer in the Northeast region (annual percentage change of 6.9%) and a decrease in the Southeast region (annual percentage change of -2.9%). Pharyngeal cancer mortality decreased in the Southeast and South regions with annual percentage change of -4.8% and -5.1% respectively. Cancer mortality for tonsil, other major salivary glands, hypopharynx, and other and unspecified parts of mouth and pharynx showed a decreasing trend while the other sites presented stability.CONCLUSIONSPharyngeal cancer mortality decreased in the period of 2002 to 2013. Oral cancer increased only in the Northeast region. Mortality for tonsil cancer, other major salivary glands, hypopharynx, and other and ill-defined sites in the lip, oral cavity, and pharynx decreased.

Abstract IA18: Tumor suppressor gene silencing by somatic mutations and promoter methylation leads to genomic instability in head and neck squamous cell carcinoma

Abstract IA18: Tumor suppressor gene silencing by somatic mutations and promoter methylation leads to genomic instability in head and neck squamous cell carcinoma

Enduring health effects of asbestos use in Belgian industries: a record-linked cohort study of cause-specific mortality (2001–2009)

ObjectiveTo investigate cause-specific mortality among asbestos workers and potentially exposed workers in Belgium and evaluate potential excess in mortality due to established and suspected asbestos-related diseases.DesignThis cohort study is based...

Oral cancer screening and dental care use among women from Ohio Appalachia

Residents of Appalachia may benefit from oral cancer screening given the region's higher oral and pharyngeal cancer mortality rates. The current study examined the oral cancer screening behaviors and recent dental care (since dentists perform most screening examinations) of women from Ohio Appalachia. Women from Ohio Appalachia were surveyed for the Community Awareness Resources Education (CARE) study, which was completed in 2006. A secondary aim of the CARE baseline survey was to examine oral cancer screening and dental care use among women from this region. Outcomes included whether women (n=477; cooperation rate = 71%) had ever had an oral cancer screening examination and when their most recent dental visit had occurred. Various demographic characteristics, health behaviors and psychosocial factors were examined as potential correlates. Analyses used multivariate logistic regression. Most women identified tobacco-related products as risk factors for oral cancer, but 43% of women did not know an early sign of oral cancer. Only 15% of women reported ever having had an oral cancer screening examination, with approximately 80% of these women indicating that a dentist had performed their most recent examination. Women were less likely to have reported a previous examination if they were from urban areas (OR=0.33, 95% CI: 0.13-0.85) or perceived a lower locus of health control (OR=0.94, 95% CI: 0.89-0.98). Women were more likely to have reported a previous examination if they had had a dental visit within the last year (OR=2.24, 95% CI: 1.03-4.88). Only 65% of women, however, indicated a dental visit within the last year. Women were more likely to have reported a recent dental visit if they were of a high socioeconomic status (OR=2.83, 95% CI: 1.58-5.06), had private health insurance (OR=2.20, 95% CI: 1.21-3.97) or had consumed alcohol in the last month (OR=2.03, 95% CI: 1.20-3.42). Oral cancer screening was not common among women from Ohio Appalachia, with many missed opportunities having occurred at dental visits. Education programs targeting dentists and other healthcare providers (given dental providers are lacking in some areas of Ohio Appalachia) about opportunistic oral cancer screening may help to improve screening in Appalachia. These programs should include information about populations at high risk for oral cancer (eg smokers) and how screening may be especially beneficial for them. Future research is needed to examine the acceptability of such education programs to healthcare providers in the Appalachian region and to explore why screening was less common among women living in urban areas of Ohio Appalachia.

Trends in oral, pharyngeal and oesophageal cancer mortality in Australia: the comparative importance of tobacco, alcohol and other risk factors

The relationship of long-term population-level trends in oral, pharyngeal and oesophageal cancer mortality with major risk factors such as tobacco consumption have not been statistically analysed in Australia. We have demonstrated the long-term implications using historical data. Estimated age and sex-specific tobacco consumption back-extrapolated to 1887 were used together with alcohol and fruit and vegetable consumption data to examine their association with trends in oral, pharyngeal and oesophageal cancer mortality. Log-linear Poisson regression models were applied to specify the relationship with oesophageal and pharyngeal mortality data. Oral cancer mortality for males decreased sharply in the first half of the 20th Century in contrast to steadily rising tobacco consumption. Female oral and pharyngeal cancer remained steady at low levels. Post-World War II male and female oesophageal and male pharyngeal cancer mortality rose, then either fell or stabilised, without a clear relationship with risk factors. Tobacco and alcohol consumption have influenced post-World War II trends in oral, pharyngeal and oesophageal cancer mortality. However, the challenges in using historical population level data prevent precise interpretation of findings. There is increased exposure to risk factors for these cancers in many low- and middle-income countries. In particular, smoking cessation programs are needed to prevent increases in mortality from these cancers in such countries.

The oral cancer epidemic in central and eastern Europe

To monitor recent trends in oral and pharyngeal cancer mortality in 38 European countries, we analyzed data provided by the World Health Organization over the period 1975-2004. Joinpoint analysis was used to identify significant changes in trends. In the European Union (EU), male mortality rates rose by 2.1% per year between 1975 and 1984, by 1.0% between 1984 and 1993, and declined by 1.3% between 1993 and 2004, to reach an overall age-standardized rate of 6.1/100,000 in 2000-2004. Mortality rates were much lower in women, and the rate in the EU rose by 0.9% per year up to 2000, and levelled off to 1.1/100,000 in 2000-2004. In France and Italy-which had the highest rates in the past-male rates have steadily declined during the last two decades (annual percent change, APC = -4.8% in 1998-2004 in France and -2.6% in 1986-2003 in Italy). Persisting rises were, however, observed in several central and eastern European countries, with exceedingly high rates in Hungary (21.1/100,000; APC = 6.9% in 1975-1993 and 1.4% in 1993-2004) and Slovakia (16.9/100,000; APC = 0.14% in 1992-2004). In middle aged (35 to 64) men, oral and pharyngeal cancer mortality rates in Hungary (55.3/100,000) and Slovakia (40.8/100,000) were comparable to lung cancer rates in several major European countries. The highest rates for women were in Hungary (3.3/100,000; APC = 4.7% in 1975-2004) and Denmark (1.6/100,000; APC = 1.3% in 1975-2001). Oral and pharyngeal cancer mortality essentially reflects the different patterns in tobacco smoking and alcohol drinking, including drinking patterns and type of alcohol in central Europe.

Cigarette smoking, alcohol drinking, and oral and pharyngeal cancer mortality in Japan

To prospectively examine the association of cigarette smoking and alcohol drinking with oral and pharyngeal carcinogenesis, we analyzed data from a nation-wide large-scale cohort study in Japan. A total of 34 136 men and 43 711 women aged 40-79 years were included in the study. The Cox proportional hazard model was used to estimate the relative risk (RR) and 95% confidence interval (95% CI) of oral and pharyngeal cancer for smoking and drinking by sex, while adjusting for age, consumption of green tea, preference for salty foods, and consumption of green yellow vegetables. Current smokers were found to have a higher risk of death caused by oral and pharyngeal cancer compared with non-smokers in both sexes: the RR was 2.6 (95% CI: 1.0-6.7) in men and 8.2 (95% CI: 2.1-32.1) in women. Men who drank more than 46 g ethanol per day had an approximately threefold increased risk of oral and pharyngeal cancer. Simultaneous exposure to both factors was significantly associated with an elevated risk of oral and pharyngeal cancer (RR: 3.3, 95% CI: 1.1-9.6). The result supports the carcinogenic effect of cigarette smoking and alcohol drinking on the oral cavity and pharynx.

Oral and pharyngeal cancer mortality rates in Mexico, 1979–2003

In Mexico, information on oral and pharyngeal cancer (OPC) is scarce. The purpose of this study was to explore the trends in OPC mortality rates in Mexico from 1979 through 2003 and to describe the distribution of OPC deaths for selected socio-demographic variables for the period of 2001-2003. Annual crude and age-adjusted mortality rates were obtained by gender and site of lesion, using the 2003 WHO World standard million population. The Poisson regression model was used to detect a trend in the mortality rates, testing the hypothesis beta(1) = 0. Also, the annual percentage change (APC) was computed over the age-adjusted rates. The total number of OPC deaths during the period 1979-2003 was 15,576. The age-adjusted mortality rate was 1.13/100,000 in 1979 and 1.08/100,000 in 2003. Oral cancer was more frequently found than salivary gland and pharyngeal cancer (41.5% vs. 13.4% and 17.1%). The tongue (19%) was the most frequent oral affected site. The Poisson regression analysis indicated a stationary trend in cancer mortality rate; also, the APC regression model showed no increase or decrease in OPC from 1979 to 2003. Oral and pharyngeal cancer mortality rates in Mexico were low compared to most countries, and remained stable in the past two decades.

Mortality from oral and pharyngeal cancer in Brazil: trends and regional patterns, 1979-2002

To investigate the trends and regional patterns in mortality from oral cancer and pharyngeal cancer in Brazil from 1979 through 2002. Data were obtained from the Mortality Information System (Sistema de Informações sobre Mortalidade) database, which is compiled by the Ministry of Health of Brazil. Mortality rates were adjusted by gender and age. The Prais-Winsten generalized linear regression procedure was used to calculate the annual increase or decrease in mortality rates. The time trends for mortality due to oral cancer and to pharyngeal cancer were analyzed by specific anatomical site and by region of the country (North, Northeast, South, Southeast, and Center-West). In all five regions of Brazil over the period studied, oral cancer mortality remained stable for both genders, but pharyngeal cancer mortality increased for both genders. Mortality from cancer affecting the lips, tongue, gums, mouth floor, palate, other parts of the mouth, and tonsils showed a statistically significant decrease over the period. However, mortality from cancer affecting the oropharynx, hypopharynx, and ill-defined and undefined sites of the oral cavity and the pharynx showed a significant increase. Mortality rates for both oral cancer and pharyngeal cancer were higher in the South and Southeast regions of the country than in Brazil's three other regions. The relatively larger decrease in mortality from cancer affecting the lips, gums, and other anatomical sites more easily accessible to clinical inspection suggests a possible link between oral and pharyngeal cancer survival and an improved provision of health care services in Brazil in recent decades.

Comparison of Oral and Pharyngeal Cancer Mortality in five Countries: France, Italy, Japan, UK and USA from the WHO Mortality Database (1960–2000)

Comparison of Oral and Pharyngeal Cancer Mortality in five Countries: France, Italy, Japan, UK and USA from the WHO Mortality Database (1960–2000)

Pharyngeal cancer mortality among chemical plant workers exposed to formaldehyde.

To assess the possible relationship between formaldehyde exposure and mortality risk from pharyngeal cancer (PC), in particular nasopharyngeal cancer (NPC). Subjects were 7328 workers employed at a plastics-producing plant (1941-1984). Vital status for 98% of the cohort and cause of death for 95% of 2872 deaths were determined. Reconstructed exposures to formaldehyde, particulates and pigment were used to compute several exposure measures. Standardized mortality ratios (SMRs) were computed for several demographic, work history and formaldehyde exposure variables. In a nested case-control study, seven cases of NPC and 15 cases of other PC were matched on race, sex, age and year of birth to four controls from the cohort. Among interviewed subjects, lifetime smoking history was determined using respondents or proxies for all but one control subject. Statistically significant 2.23-fold and fivefold excesses for PC and NPC, respectively, were observed. Fivefold range NPC excesses were observed for both short ( < 1 year) and long-term workers and were concentrated among workers hired during 1947-1956. Only three NPC cases were exposed to formaldehyde for longer than one year, and each had low average intensity of formaldehyde exposure (0.03-0.60 ppm). Only a few exposure measures revealed some evidence of an association with all PC or NPC. For all PC combined, adjustment for smoking and year-of-hire in the case-control study generally corroborated findings from the cohort study. Overall, the pattern of findings suggests that the large, persistent nasopharyngeal and other PC excesses observed among the Wallingford workforce are not associated with formaldehyde exposure, and may reflect the influence of nonoccupational risk factors or occupational risk factors associated with employment outside the Wallingford plant.

Perspectives of Maryland adult and family practice nurse practitioners on oral cancer.

Because oral and pharyngeal cancer mortality in Maryland ranks seventh among states and sixth for black males, a statewide oral cancer needs assessment was conducted. The purposes of this qualitative descriptive study were to obtain indepth information on nurse practitioners' awareness and opinions of oral cancer, oral cancer examinations, and related factors. These findings were intended to supplement a previous survey conducted among Maryland nurse practitioners. A professional focus group moderator conducted one face-to-face focus group with 11 nurse practitioners and one telephone focus group with eight nurse practitioners. Criterion-purposeful sampling and qualitative content analysis were employed. Findings showed that oral cancer is a neglected public health problem and, based on their formal training, not one considered by nurse practitioners to be their responsibility. Although aware of other cancers, none of the nurse practitioners recognized that oral cancer was a public health problem in the state. Numerous barriers were cited for this neglect, including their lack of training and, in one case, unpleasant feelings about examining the mouth. Participants concluded that oral cancer is part of their responsibilities and that they are interested in related continuing education courses. The focus groups of nurse practitioners provided rich and insightful suggestions for future strategies to help solve the oral cancer problem in Maryland, which supplemented the quantitative mail survey conducted earlier.