de la Cour Cecilie Dovey, Munk Christian, Aalborg Gitte Lerche, Kjaer Susanne Krüger
Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark.
Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark.
Oral Oncol. 2022 May;128:105832. doi: 10.1016/j.oraloncology.2022.105832. Epub 2022 Apr 9.
Base-of-tongue (BOT)/tonsillar cancer incidence is rising, primarily due to human papillomavirus; meanwhile, rates of the mainly smoking-associated laryngeal cancer is declining. Little is known about whether these trends are seen in all socioeconomic levels and age-groups. We describe incidence trends of BOT/tonsillar and laryngeal cancer in Denmark 1994-2018 by educational level and age.
BOT/tonsillar and laryngeal cancer cases diagnosed 1994-2018 were identified from the Danish Cancer Registry. We obtained individual-level educational information from nationwide registries. We estimated age-standardized incidence rates of BOT/tonsillar and laryngeal cancer according to sex, education and age. Temporal incidence trends were evaluated by the average annual percentage change (AAPC) with corresponding 95% confidence intervals (CIs) using linear and Poisson regression models for age-standardized incidence rates.
We identified 4245 individuals with BOT/tonsillar cancer and 6123 with laryngeal cancer. BOT/tonsillar cancer incidence increased among men with short (AAPC:3.4, 95% CI 2.1;4.6) and long (AAPC:5.1, 95% CI 3.2;7.1) education, and all age-groups, while decreased from 2012 among men with medium education (AAPC:-4.3, 95 %CI -7.6;-1.0). Laryngeal cancer incidence decreased from 2007 in men with medium (AAPC:-4.7, 95% CI -6.7;-2.7) and long (AAPC:-2.4, 95% CI -3.4;-1.4) education, and all age-groups, whereas increased in men with short education (AAPC:1.0, 95% CI 0.2;1.8). Similar trends were seen among women.
Over the last 25 years, BOT/tonsillar cancer incidence in Denmark has generally increased in all age-groups and educational levels. In contrast, social inequality was seen in laryngeal cancer trends as incidence decreased in individuals with medium and long education, while incidence increased in individuals with short education.
舌根（BOT）/扁桃体癌的发病率正在上升，主要归因于人乳头瘤病毒；与此同时，主要与吸烟相关的喉癌发病率正在下降。对于这些趋势是否在所有社会经济水平和年龄组中都存在，人们知之甚少。我们按教育程度和年龄描述了1994 - 2018年丹麦舌根/扁桃体癌和喉癌的发病趋势。
从丹麦癌症登记处识别出1994 - 2018年诊断的舌根/扁桃体癌和喉癌病例。我们从全国登记处获取个人层面的教育信息。我们根据性别、教育程度和年龄估计舌根/扁桃体癌和喉癌的年龄标准化发病率。使用线性和泊松回归模型对年龄标准化发病率，通过平均年度百分比变化（AAPC）及其相应的95%置信区间（CIs）评估发病时间趋势。
我们识别出4245例舌根/扁桃体癌患者和6123例喉癌患者。舌根/扁桃体癌发病率在受教育时间短（AAPC：3.4，95% CI 2.1；4.6）和受教育时间长（AAPC：5.1，95% CI 3.2；7.1）的男性以及所有年龄组中均有所上升，而在受教育时间中等的男性中，自2012年起发病率下降（AAPC： - 4.3，95% CI - 7.6； - 1.0）。喉癌发病率在受教育时间中等（AAPC： - 4.7，95% CI - 6.7； - 2.7）和受教育时间长（AAPC： - 2.4，95% CI - 3.4； - 1.4）的男性以及所有年龄组中自2007年起下降，而在受教育时间短的男性中发病率上升（AAPC：1.0，95% CI 0.2；1.8）。女性中也观察到类似趋势。
在过去25年中，丹麦舌根/扁桃体癌的发病率在所有年龄组和教育水平中总体呈上升趋势。相比之下，喉癌趋势存在社会不平等现象，因为受教育时间中等和长的个体发病率下降，而受教育时间短的个体发病率上升。
