Based on the results of a cross-sectional epidemiologic analysis published in JAMA Network Open, the incidence of oropharyngeal cancer has increased among older individuals in the United States. According to Cao et al, those with localized disease appeared to be undertreated, indicating the need for further research to optimize outcomes.
Study Details
Data on oropharyngeal cancer incidence, prevalence, survival, and initial treatment by stage were sourced from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-22 database (excluding Illinois and Massachusetts).
The primary outcomes included annual age-adjusted oropharyngeal cancer incidence per 100,000 persons, limited-duration prevalence, survival rate, and initial treatment. The incidence rate and estimated annual percentage change for the most recent period were determined using trend analysis from 2006 to 2021 and subsequently applied to project rates through 2040.
Key Findings
A total of 103,107 new oropharyngeal cancer cases (40,051 patients [38.8%] aged ≥ 65 years; 82,820 males [80.3%]) were recorded between 2006 and 2021. During this period, the incidence of oropharyngeal cancer increased from 3.8 to 4.4 cases per 100,000 person-years. The projected incidence rates were found to indicate a significant decrease for both female (1.1 cases per 100,000 person-years) and younger (aged < 65 years; 2.0 cases per 100,000 person-years) patients in 2040. The 10-year limited-duration prevalence rose from 0.024% in 2012 to 0.033% in 2021. The 1-, 3-, and 5-year period survival rates were 88.2% (95% confidence interval [CI] = 87.7%–88.7%), 76.5% (95% CI = 75.9%–77.1%), and 69.2% (95% CI = 68.5%–69.9%), respectively.
Of the 7,495 patients with oropharyngeal cancer in 2021, initially, 1,621 (21.6%) received no treatment, 1,647 (22.0%) received a single treatment, and 4,227 (56.4%) received multiple treatments. The distribution of treatments seemed to remain consistent from 2006 to 2021. Close to half of the patients with localized stage disease (7,171 of 15,648 [45.8%]) received no treatment. In 2021, a higher proportion of patients aged at least 65 years received no treatment compared with those younger than age 65 (865 of 3,525 [24.5%] vs 756 of 3,970 [19.0%]).
The investigators concluded, “In this cross-sectional study of oropharyngeal cancer, the incidence of oropharyngeal cancer in the U.S. increased rapidly from 2006 to 2021 among male individuals, particularly among those aged 65 years and older. Although the distribution of treatment was similar through the assessed years, increased limited-duration prevalence and higher than previously reported survival were observed. A smaller proportion of patients with localized-stage oropharyngeal cancer were treated, especially among those aged 65 years and older, suggesting that further research is needed for optimal patient outcomes.”
Nancy Y. Lee, MD, of Memorial Sloan Kettering Cancer Center, New York, is the corresponding author of the article in JAMA Network Open.
Disclosure: The study was funded in part by the National Institutes of Health. For full disclosures of the study authors, visit jamanetwork.com.
