Trends in Incidence and Mortality of Head and Neck Cancer Subsites Among Elderly Patients: A Population-Based Analysis
Małgorzata Wierzbicka, Wioletta Pietruszewska, Adam Maciejczyk, Jarosław Markowski
Abstract
The incidence of head and neck cancer (HNC) has significantly increased over the past two decades. Material and methods: This study analyzed trends in HNC incidence and mortality using data from the Polish Cancer Register (1999–2021) across three age cohorts (60–69, 70–79, and 80+) and projected trends through to 2035. Statistical analyses included regression, correlation, and parallelism tests, with significance levels of α = 0.05 and Bonferroni correction applied (αc ≈ 0.017). Results: In the 60–69 cohort, incidence rates increased faster than mortality rates (p < 0.001), especially for oral and oropharyngeal cancers in women (p < 0.001). For the 70–79 cohort, mortality rates rose slower than incidence (p < 0.05), most notably for salivary gland cancers across genders and oral cavity cancers in women. In the 80+ group, both incidence and mortality increased (p < 0.05), but mortality rates rose faster for laryngeal, hypopharyngeal, and oral cancers in men and the general population (p < 0.017). The largest increases were observed in oral cancer among women, with a marked rise across all age groups (p < 0.001). Gender-specific patterns highlighted stable or modestly rising trends in males but a notable increase in females, particularly in the 80+ group. Conclusions: These findings underscore that older patients are not a homogeneous group in terms of HNC incidence and survival. This study emphasizes age- and gender-specific strategies for prevention and management. Expanding HPV vaccination and improving early detection are crucial, particularly for high-risk groups like older women and those with HPV-related cancers. Tailored approaches could mitigate rising trends and improve survival outcomes.