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Temporal trends in oropharyngeal cancer incidence, survival, and cancer-directed surgery among elderly Americans.

Publication ,  Conference
Chidambaram, S; Hong, SA; Simpson, MC; Osazuwa-Peters, N; Ward, GM; Massa, ST
Published in: Oral Oncol
November 2022

OBJECTIVE: This study assesses longitudinal epidemiologic trends in the oldest head and neck cancer (HNC) patients, comparing the oropharynx to other mucosal HNC sites. MATERIALS AND METHODS: Using data from the Surveillance, Epidemiology, and End Results database, trends in incidence, two-year cancer specific mortality, and percent of cases recommended for and which received surgery from 2000 to 2018 in patients ages ≥85 years were assessed using Joinpoint analysis by HNC site. Trends were quantified as annual percentage change (APC) with 95% confidence intervals (CI). RESULTS: Among older adults, oropharyngeal cancer (OPC) incidence increased (APC = 1.80% [95% CI: 0.94-2.67]), while mortality decreased (APC = -2.01% [95% CI: -3.26--0.74]) from 2000 to 2018. At other mucosal HNC sites, incidence and mortality remained stable. Percentage of patients who received surgery significantly changed for oropharyngeal (APC = -15.34% from 2000 to 2005 [95% CI: -24.37 to -4.79]) and laryngeal (APC = -4.61% from 2000 to 2008 [95% CI -8.28 to -0.80]) cancers. Trends in recommendation for surgery varied by site with significant decreases at the larynx, oral cavity, and oropharynx. CONCLUSION: OPC incidence is increasing among the oldest HNC patients. An increasing proportion of HPV-associated tumors could account for associated mortality improvement. There has been a shift towards non-surgical therapy possibly due to known favorable response of HPV-associated OPC to radiation therapy and/or poor surgical candidacy in this age group. The evolving treatment approach has not been detrimental to population-level survival outcomes, but optimal treatment has yet to be established. Future studies with pathologically confirmed HPV status are needed to better understand older adult OPC burden.

Duke Scholars

Published In

Oral Oncol

DOI

EISSN

1879-0593

Publication Date

November 2022

Volume

134

Start / End Page

106132

Location

England

Related Subject Headings

  • United States
  • Papillomavirus Infections
  • Oropharyngeal Neoplasms
  • Oncology & Carcinogenesis
  • Incidence
  • Humans
  • Head and Neck Neoplasms
  • Dentistry
  • Aged, 80 and over
  • Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chidambaram, S., Hong, S. A., Simpson, M. C., Osazuwa-Peters, N., Ward, G. M., & Massa, S. T. (2022). Temporal trends in oropharyngeal cancer incidence, survival, and cancer-directed surgery among elderly Americans. In Oral Oncol (Vol. 134, p. 106132). England. https://doi.org/10.1016/j.oraloncology.2022.106132
Chidambaram, Smrithi, Scott A. Hong, Matthew C. Simpson, Nosayaba Osazuwa-Peters, Gregory M. Ward, and Sean T. Massa. “Temporal trends in oropharyngeal cancer incidence, survival, and cancer-directed surgery among elderly Americans.” In Oral Oncol, 134:106132, 2022. https://doi.org/10.1016/j.oraloncology.2022.106132.
Chidambaram S, Hong SA, Simpson MC, Osazuwa-Peters N, Ward GM, Massa ST. Temporal trends in oropharyngeal cancer incidence, survival, and cancer-directed surgery among elderly Americans. In: Oral Oncol. 2022. p. 106132.
Chidambaram, Smrithi, et al. “Temporal trends in oropharyngeal cancer incidence, survival, and cancer-directed surgery among elderly Americans.Oral Oncol, vol. 134, 2022, p. 106132. Pubmed, doi:10.1016/j.oraloncology.2022.106132.
Chidambaram S, Hong SA, Simpson MC, Osazuwa-Peters N, Ward GM, Massa ST. Temporal trends in oropharyngeal cancer incidence, survival, and cancer-directed surgery among elderly Americans. Oral Oncol. 2022. p. 106132.
Journal cover image

Published In

Oral Oncol

DOI

EISSN

1879-0593

Publication Date

November 2022

Volume

134

Start / End Page

106132

Location

England

Related Subject Headings

  • United States
  • Papillomavirus Infections
  • Oropharyngeal Neoplasms
  • Oncology & Carcinogenesis
  • Incidence
  • Humans
  • Head and Neck Neoplasms
  • Dentistry
  • Aged, 80 and over
  • Aged