Song Jin Soo, Vallance Patrick, Biron Vincent, Jeffery Caroline C
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of Alberta, 1E4 Walter Mackenzie Centre, 8440-112 Street NW, Edmonton, Alberta, T6G 2B7, Canada.
J Otolaryngol Head Neck Surg. 2020 Jul 6;49(1):46. doi: 10.1186/s40463-020-00443-4.
With an increase in the incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) and more favourable survival outcomes, there is now a population of head and neck cancer survivors that are different from preceding decades. In addition, their long-term survivorship issues have become increasing research interests. This study was undertaken to determine the changing epidemiological trends of head and neck cancer survivors in Alberta to better anticipate future demands on healthcare services.
The Alberta Cancer Registry was queried for adult (aged > 18 years), head and neck cancer (HNC) patients who were at least 1-year post-treatment completion between 1997 to 2016. Cutaneous head and neck and thyroid cancer patients were excluded. Extracted data was then used to calculate the incidence and prevalence of early (< 5 years from treatment), intermediate (5 to < 10 years from treatment), and late (> 10 years from treatment) survivors of head and neck cancer. Point prevalence of HNC survivors in 2005, 2010, and 2015 were then further stratified by gender, sub-site and age.
Over this time period, head and neck cancer survivors tended to be younger (64.0 vs. 62.1, p = 0.046) and male (M:F 2.45:1 vs 2.54:1). In 1997, the predominant subsites were the oral cavity and larynx at 45.8% and 30.9%, respectively. In 2015 the predominant subsites were the oral cavity and oropharynx at 33.0% and 29.4%, respectively. Within the cohort, the prevalence of late HNC survivors increased to 13.3 per 100,000 people in 2015.
There is a significant population of head and neck survivors who are younger, male, and more than 10 years post-treatment. While oral cavity cancers have shown stable disease prevalence in recent decades, the number of OPSCC survivors have increased. With an improved understanding of the distribution and characteristics of HNC survivors, a more guided healthcare support network can be fostered for these patients.
随着人乳头瘤病毒（HPV）相关的口咽鳞状细胞癌（OPSCC）发病率的上升以及生存结果更为乐观，现在有一群头颈癌幸存者与过去几十年有所不同。此外，他们的长期生存问题越来越受到研究关注。本研究旨在确定艾伯塔省头颈癌幸存者不断变化的流行病学趋势，以便更好地预测未来对医疗服务的需求。
查询艾伯塔癌症登记处，获取1997年至2016年间完成治疗至少1年的成年（年龄>18岁）头颈癌（HNC）患者。皮肤头颈癌和甲状腺癌患者被排除。然后使用提取的数据计算头颈癌早期（治疗后<5年）、中期（治疗后5至<10年）和晚期（治疗后>10年）幸存者的发病率和患病率。然后按性别、亚部位和年龄进一步分层，分析2005年、2010年和2015年头颈癌幸存者的点患病率。
在此期间，头颈癌幸存者往往更年轻（64.0岁对62.1岁，p = 0.046）且男性居多（男：女为2.45:1对2.54:1）。1997年，主要亚部位分别是口腔和喉部，占比分别为45.8%和30.9%。2015年，主要亚部位分别是口腔和口咽，占比分别为33.0%和29.4%。在该队列中，2015年末期头颈癌幸存者的患病率增至每10万人中有13.3人。
有相当数量的头颈癌幸存者更年轻、为男性且治疗后超过10年。虽然近几十年来口腔癌的疾病患病率保持稳定，但口咽鳞状细胞癌幸存者的数量有所增加。随着对头颈癌幸存者分布和特征的进一步了解，可以为这些患者建立更有针对性的医疗支持网络。
