美国头颈部鳞状细胞癌较为罕见，与黑人相比，现在白人的患病风险更高。
Head and neck squamous cell cancers in the United States are rare and the risk now is higher among white individuals compared with black individuals.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, Maryland.
Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Medicine, Baltimore, Maryland.
出版信息
Cancer. 2018 May 15;124(10):2125-2133. doi: 10.1002/cncr.31322. Epub 2018 Mar 13.
BACKGROUND
The increasing incidence of oropharyngeal squamous cell cancer (OPSCC) is well established. However, up-to-date incidence estimates and trends for head and neck squamous cell cancers (HNSCCs) overall, including major anatomic sites, and nonoropharyngeal (non-OP) HNSCCs by sex, race, and age in the United States are not well described.
METHODS
A retrospective analysis of incident HNSCCs during 1992 through 2014 using the Surveillance, Epidemiology, and End Results database was performed to evaluate the incidence of HNSCCs overall, OPSCC, and non-OP HNSCC (those of the larynx, oral cavity, hypopharynx, nasopharynx, and nasal cavity). Incidence rates were calculated overall and by subgroups of interest, and incidence rate ratios were used to compare rates between groups. The incidence rates presented were per 100,000 population and were age adjusted to the 2000 US standard population (19 age groups; Census P25-1130). The annual percent change (APC) was modeled with and without joinpoints.
RESULTS
The incidence of HNSCC overall declined (average APC [aAPC], -0.8; P<.001) despite significant increases in the incidence of OPSCCs, most notably between 2000 and 2014 (APC, 2.1; P<.001). Significant declines in incidence were observed for all non-OP HNSCC sites for both women and men (P<.001 each). Among women, the risk of OPSCC also significantly decreased (aAPC, -0.8; P = .002), whereas the risk among men was stable during 1992 through 2001 (APC, 0.4; P = .42) and then significantly increased from 2001 to 2014 (APC, 2.7; P<.001). Decreases in the risk of non-OP HNSCC were especially large for black women (aAPC, -2.6; P<.001) and men (aAPC, -3.0; P<.001). Although the incidence of HNSCC previously was highest among black individuals, since 2009 its incidence has been higher among white compared with black individuals.
CONCLUSIONS
The incidence of HNSCC is declining, especially for non-OP HNSCC and among black individuals. Cancer 2018;124:2125-33. © 2018 American Cancer Society.
背景
口咽鳞状细胞癌（OPSCC）的发病率不断上升，这一事实已得到充分证实。然而，目前尚不清楚美国总体头颈部鳞状细胞癌（HNSCC）的最新发病率估计和趋势，包括主要解剖部位以及非口咽（非 OP）HNSCC 按性别、种族和年龄的发病率。
方法
使用监测、流行病学和最终结果（SEER）数据库，对 1992 年至 2014 年期间发生的 HNSCC 进行回顾性分析，以评估 HNSCC 总体、OPSCC 和非 OP HNSCC（喉、口腔、下咽、鼻咽和鼻腔）的发病率。计算了总体发病率和感兴趣的亚组的发病率，并使用发病率比值来比较组间的发病率。报告的发病率为每 100000 人，并按年龄调整为 2000 年美国标准人口（19 个年龄组；人口普查 P25-1130）。通过加入和不加入连接点来模拟每年的百分比变化（APC）。
结果
尽管 OPSCC 的发病率显著上升，尤其是在 2000 年至 2014 年期间（APC，2.1；P<.001），但 HNSCC 总体的发病率仍呈下降趋势（平均 APC [aAPC]，-0.8；P<.001）。所有女性和男性的非 OP HNSCC 部位的发病率均显著下降（P<.001 各）。在女性中，OPSCC 的风险也显著降低（aAPC，-0.8；P =.002），而男性的风险在 1992 年至 2001 年期间保持稳定（APC，0.4；P =.42），然后从 2001 年至 2014 年显著增加（APC，2.7；P<.001）。黑人女性（aAPC，-2.6；P<.001）和男性（aAPC，-3.0；P<.001）的非 OP HNSCC 风险下降尤其显著。尽管 HNSCC 的发病率以前在黑人中最高，但自 2009 年以来，其发病率在白人中高于黑人。
结论
HNSCC 的发病率正在下降，特别是对于非 OP HNSCC 和黑人。癌症 2018；124:2125-33。© 2018 美国癌症协会。
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