Oral cavity and pharynx cancer incidence trends by subsite in the United States: changing gender patterns

Abstract

Objective. To evaluate oral cavity and pharynx cancer (OCPC) patterns by gender. Methods. We used Surveillance, Epidemiology, and End Results program data for 71,446 cases diagnosed during 1975-2008 to classify OCPC by anatomic subsite as potentially HPV-related or not, with oral tongue cancer considered a separate category. Results. Total OCPC rates among men were 2-4 times those among women. Among whites, total OCPC rates rose in the younger age groups due to substantial increases in successive birth cohorts for HPV-related cancers, more rapid among men than women, and oral tongue cancers, more rapid among women than men. Among blacks, total OCPC rates declined among cohorts born since 1930 reflecting the strong downward trends for HPV-unrelated sites. Among Hispanics and Asians, HPV-unrelated cancer rates generally declined, and oral tongue cancer rates appeared to be converging among young men and women. Conclusions. Decreases in total OCPC incidence reflect reductions in smoking and alcohol drinking. Rising HPV-related cancers among white men may reflect changing sexual practices. Reasons for the increasing young oral tongue cancer rates are unknown, but the narrowing of the gender differences provides a clue.

Figure 1

Trends in age-adjusted (2000 US standard) squamous cell carcinoma of the oral cavity and pharynx incidence rates by race/ethnicity, subsite, and gender for whites and blacks SEER 9 1975–1979 to 2004–2008 and for whites (non-Hispanic), blacks, Hispanics (white), and Asian/PIs SEER 13 1992–1997 to 2004–2008 according to year of diagnosis (excludes lip, salivary glands, and nasopharynx). Shaded bands portray 95% confidence intervals.

Figure 2

Trends in age-specific squamous cell carcinoma of the oral cavity and pharynx incidence rates by race/ethnicity, subsite, and gender for whites and blacks SEER 9 1975–1979 to 1986–1991 and for whites (non-Hispanic), blacks, Hispanics (white), and Asian/PIs SEER 13 1992–2008 according to year of birth (excludes lip, salivary glands, and nasopharynx) (rates age-adjusted within age group).

Figure 3

Trends in age-specific squamous cell carcinoma of the oral cavity and pharynx male/female incidence rate ratios among whites by subsite SEER 9 1975–1979 to 1986–1991 and whites (non-Hispanic) SEER 13 1992–2008 according to year of birth (excludes lip, salivary glands, and nasopharynx).