Department of Otolaryngology, Head and Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, United States.
Department of Surgical Oncology, Division of Head and Neck Surgery, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, United States.
Oral Oncol. 2019 Apr;91:65-68. doi: 10.1016/j.oraloncology.2019.02.024. Epub 2019 Mar 4.
Oropharynx cancer incidence trends in low socioeconomic (SES) regions of the United States (US) have not been well described. Our objective was to describe tonsil cancer incidence trends in low SES regions, and compare observed trends with those for larynx cancer.
Age-adjusted incidence rates and trends for tonsil and larynx squamous cell carcinomas (2000-14) from Surveillance, Epidemiology, and End Results (SEER 18) were evaluated using SEER*Stat and Joinpoint 4.5.0.1. Annual percentage changes (APCs) were compared between low and high SES counties. The laryngeal cancer cohort was included as a comparator reflecting a tobacco-related malignancy.
Tonsil cancer incidence trends increased at least as much in low SES as in high SES counties (APC/AAPC 4.4, 95%CI 2.4-6.4 versus APC/AAPC 2.9, 95%CI 2.4-3.3). Pairwise comparison confirmed no differences between incidence trends across SES quintiles for tonsil cancer incidence rates. In contrast, age-adjusted incidence rates of larynx cancer decreased in high SES counties (APC/AAPC -2.4, 95%CI -2.4 to -2.0, p < 0.001) and were stable in low SES counties (APC/AAPC -0.9, 95%CI -1.9 to 0.2, p = 0.10). Compared with larynx cancer patients, tonsil cancer patients in low SES regions were significantly more likely to be younger and white.
In low SES US counties, tonsil cancer incidence rates increased from 2000 to 2014, while larynx cancer rates did not change, reflecting diverging trends for larynx and tonsil cancers. Tonsil cancer incidence rates are increasing in most US regions regardless of regional socioeconomic status. Prevention efforts should take these findings into account.
美国（US）社会经济地位（SES）较低地区的口咽癌发病率趋势尚未得到很好的描述。我们的目的是描述 SES 较低地区扁桃体癌的发病率趋势，并将观察到的趋势与喉癌进行比较。
使用 SEER*Stat 和 Joinpoint 4.5.0.1 评估了 2000-14 年来自监测、流行病学和最终结果（SEER 18）的扁桃体和喉鳞状细胞癌的年龄调整发病率和趋势。低 SES 和高 SES 县之间比较了年度百分比变化（APC）。将喉癌队列作为反映与烟草相关的恶性肿瘤的对照纳入。
至少在低 SES 县，扁桃体癌的发病率趋势增加了（APC/AAPC 4.4，95%CI 2.4-6.4 与 APC/AAPC 2.9，95%CI 2.4-3.3）。两两比较证实，扁桃体癌发病率的 SES 五分位数之间的发病趋势没有差异。相比之下，高 SES 县的喉癌年龄调整发病率下降（APC/AAPC-2.4，95%CI-2.4 至-2.0，p<0.001），而低 SES 县的发病率稳定（APC/AAPC-0.9，95%CI-1.9 至 0.2，p=0.10）。与喉癌患者相比，低 SES 地区的扁桃体癌患者更年轻且更可能是白人。
在 SES 较低的美国县，扁桃体癌的发病率从 2000 年到 2014 年增加，而喉癌的发病率没有变化，反映了喉癌和扁桃体癌的趋势不同。无论区域社会经济地位如何，大多数美国地区的扁桃体癌发病率都在增加。预防工作应考虑到这些发现。
