Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
Department of Health Science Research, Section of Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, USA.
Clin Otolaryngol. 2021 Nov;46(6):1205-1212. doi: 10.1111/coa.13817. Epub 2021 Jun 24.
Several independent studies report an alarming increase in patients younger than 40 being diagnosed with squamous cell carcinoma. There is currently a lack of available data clearly tracking changes in the age distribution of head and neck cancer (HNC) within the United States. This study attempts to elucidate any trends in oral cavity, oropharynx, larynx and hypopharynx cancer age distribution in the United States population from 1975 to 2016. Unlike previous studies, this paper does not track incidence but rather reports proportional changes of prevalence within age cohorts over time.
This is a retrospective chart review centred on data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI). Each decade interval from 1975 to 2016 displays the proportion of HNC patients, classified by primary tumour subsite, within each age cohort.
Mean age at diagnosis increased for all subsites except oropharynx. Oropharyngeal cancer was the only subsite to show a decrease in the mean age at diagnosis. In addition, oropharyngeal cancer was the only subsite to demonstrate an overall increase in proportional prevalence, largely due to increased incidence in middle-age (40-59 years) patients. Cancers of the oral cavity were the only subset to show a true increase in the proportion of young (0-39 years) patients, but its mean age at diagnosis still increased. When stratifying by gender, the proportion of young patients in female HNC cases is higher than the young male proportion.
Overall, this study demonstrates an increased proportion of older HNC patients that is consistent with the ageing population. Oral cavity cancer demonstrated a true increase in the proportion of young patients, likely due to the increased incidence of young women diagnosed with this cancer. Oropharyngeal cancer was the only subsite to show a decrease in the mean age at diagnosis. The increased proportion of middle-age patients with oropharyngeal cancer likely reflects the increase in HPV-related cancers.
多项独立研究报告称，40 岁以下被诊断患有鳞状细胞癌的患者数量令人震惊地增加。目前，缺乏明确跟踪美国头颈部癌症（HNC）年龄分布变化的可用数据。本研究试图阐明美国人群中 1975 年至 2016 年口腔、口咽、喉和下咽癌年龄分布的任何趋势。与之前的研究不同，本文不跟踪发病率，而是报告随时间推移在年龄组内患病率的比例变化。
这是一项回顾性图表审查，以美国国家癌症研究所（NCI）的监测、流行病学和最终结果（SEER）计划的数据为中心。1975 年至 2016 年的每个十年间隔显示了按主要肿瘤部位分类的 HNC 患者在每个年龄组中的比例。
除了口咽癌外，所有部位的诊断时平均年龄都有所增加。口咽癌是唯一诊断时平均年龄降低的部位。此外，口咽癌是唯一显示总体患病率比例增加的部位，主要是由于中年（40-59 岁）患者的发病率增加。口腔癌是唯一显示年轻（0-39 岁）患者比例真正增加的亚组，但诊断时的平均年龄仍在增加。按性别分层时，女性 HNC 病例中年轻患者的比例高于年轻男性比例。
总的来说，这项研究表明，老年 HNC 患者的比例增加与人口老龄化一致。口腔癌显示出年轻患者比例的真正增加，可能是由于年轻女性确诊这种癌症的发病率增加所致。口咽癌是唯一诊断时平均年龄降低的部位。口咽癌中年患者比例增加可能反映了 HPV 相关癌症的增加。
