The Burden of Head and Neck Cancer in the United States, 1990 - 2017

Purpose Head and neck cancers (HNC) are among the most common malignancies in the United States and are a significant cause of morbidity and mortality. Traditional risk factors for HNC include tobacco, alcohol, and Human Papilloma Virus (HPV) infection. Geographic location has also been shown to play a role, whether directly or indirectly. The purpose of this study was to describe the incidence, mortality and geographic variability of HNC within the United States between 1990 and 2017. Materials and Methods The Global Burden of Diseases Study 2017, which models incidence and mortality, was used to obtain incidence and mortality data for “lip and oral cavity cancer”, “nasopharynx cancer”, “other pharynx cancer” (tonsil, oropharynx, and hypopharynx) and “larynx cancer” for the United States between 1990 and 2017. Results The overall incidence rate of HNC increased (annual percent change (APC) = 0.23. 95% CI: 0.1-0.3) from 1990 through 2017 while overall mortality decreased (APC = -0.37. 95% CI: -0.4 to -0.3). The anatomic sub-site which saw the largest increase in incidence was “other pharynx” (APC=1.07. 95% CI: 0.9-1.2). In 2017, those in the West had the lowest incidence while those in the South had the highest (15.7 and 20.8 per 100,000 individuals, respectively). Conclusions The incidence of HNC in the United States increased between 1990 and 2017. This was driven by larger increases in those sites more prone to HPV-related HNC. While there exists geographic variability in the burden of this disease, additional studies are needed to further understand the impact of patient-specific factors.