Polednak Anthony P
J Registry Manag. 2018 Summer;45(2):65-71.
For squamous cell carcinoma (SCC) of the base of tongue and palatine tonsil, the oropharyngeal sites most strongly associated with human papillomavirus (HPV), increasing age-standardized incidence rates (ASIRs) (2002-2012) have been reported for elderly US men but not women. These findings were based on data from Surveillance, Epidemiology, and End Results (SEER) registries, covering 28% of the US population.
Trends in ASIRs (2001- 2014) at ages ≥65 years for base of tongue-palatine tonsil SCC were analyzed using a SEER research database, along with a US Cancer Statistics (USCS) research database with registries covering 48 states (98% of the US population). Annual percent change in ASIR was estimated using joinpoint regression.
Using either SEER or USCS, ASIRs for ages ≥65 years increased after the late 2000s for women, whereas men showed a larger and more continuous increase during 2001-2014. Increases were evident for the age subgroups 65-74 and 75-84 years, but the trend for women aged 75-84 years was clearer using USCS vs SEER. For 2003-2014, the 38 states in USCS that were certified by the North American Association of Central Cancer Registries showed increases for women and men that were similar to those using all 48 USCS states or SEER.
Continued surveillance is needed, along with studies on HPV markers in tumor tissues for large samples of elderly oropharyngeal SCC patients. Findings support the need for expanding resources for diagnosis, treatment and clinical trials for the growing numbers of elderly oropharyngeal SCC patients.
对于舌根和腭扁桃体鳞状细胞癌(SCC),这两个口咽部位与人乳头瘤病毒(HPV)关联最为密切,据报道,美国老年男性的年龄标准化发病率(ASIRs)在上升(2002 - 2012年),但女性并非如此。这些发现基于监测、流行病学和最终结果(SEER)登记处的数据,覆盖美国28%的人口。
使用SEER研究数据库分析≥65岁人群舌根 - 腭扁桃体SCC的ASIRs(2001 - 2014年)趋势,同时使用覆盖48个州(占美国人口98%)登记处的美国癌症统计(USCS)研究数据库。使用连接点回归估计ASIR的年度百分比变化。
使用SEER或USCS数据,2000年代后期之后≥65岁女性的ASIRs上升,而男性在2001 - 2014年期间上升幅度更大且更为持续。65 - 74岁和75 - 84岁年龄亚组的发病率均有上升,但使用USCS数据时75 - 84岁女性的趋势比SEER数据更明显。对于2003 - 2014年,北美中央癌症登记协会认证的USCS中的38个州显示,女性和男性的发病率上升情况与使用全部48个USCS州或SEER数据时相似。
需要持续监测,同时对大量老年口咽SCC患者的肿瘤组织进行HPV标志物研究。研究结果支持为越来越多的老年口咽SCC患者扩大诊断、治疗和临床试验资源的必要性。