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. 2024 May 1;150(5):436-443.
doi: 10.1001/jamaoto.2024.0301.

Trends in Oral Tongue Cancer Incidence in the US

Todd Burus  1 , Haluk Damgacioglu  2   3 , Bin Huang  1   4   5 , W Jay Christian  6 , Pamela C Hull  1   7 , Amanda R Ellis  8 , Susanne M Arnold  1   9 , Ashish A Deshmukh  2   3 , Krystle A Lang Kuhs  1   6
Affiliations

Trends in Oral Tongue Cancer Incidence in the US

Todd Burus et al. JAMA Otolaryngol Head Neck Surg. .

Abstract

Importance: Oral tongue cancer (OTC) incidence has increased rapidly among young (<50 years) non-Hispanic White individuals in the US during the past 2 decades; however, it is unknown if age-associated trajectories have persisted.

Objective: To examine US trends in OTC incidence and project future case burden.

Design, setting, and participants: This cross-sectional analysis of OTC incidence trends used the US Cancer Statistics Public Use Database, which covers approximately 98% of the US population, and included individuals with an OTC diagnosis reported to US cancer registries between January 1, 2001, and December 31, 2019.

Exposures: Sex, race and ethnicity, and age.

Main outcomes and measures: Estimated average annual percentage change in OTC incidence from 2001 to 2019. Given the substantial incidence rate increases among non-Hispanic White individuals compared with those of racial and ethnic minority groups, subsequent analyses were restricted to non-Hispanic White individuals. Forecasted OTC incidence trends and case burden among non-Hispanic White individuals to 2034.

Results: There were 58 661 new cases of OTC identified between 2001 and 2019. Male individuals (57.6%), non-Hispanic White individuals (83.7%), those aged 60 years or older (58.0%), and individuals with localized stage disease at diagnosis (62.7%) comprised most cases. OTC incidence increased across all age, sex, and racial and ethnic groups, with marked increases observed among non-Hispanic White individuals (2.9% per year; 95% CI, 2.2%-3.7%). Increases among female individuals aged 50 to 59 years were most notable and significantly outpaced increases among younger non-Hispanic White female individuals (4.8% per year [95% CI, 4.1%-5.4%] vs 3.3% per year [95% CI, 2.7%-3.8%]). While all non-Hispanic White birth cohorts from 1925 to 1980 saw sustained increases, rates stabilized among female individuals born after 1980. Should trends continue, the burden of new OTC cases among non-Hispanic White individuals in the US is projected to shift more toward older individuals (from 33.1% to 49.3% among individuals aged 70 years or older) and female individuals (86% case increase vs 62% among male individuals).

Conclusions and relevance: The results of this cross-sectional study suggest that the period of rapidly increasing OTC incidence among younger non-Hispanic White female individuals in the US is tempering and giving way to greater increases among older female individuals, suggesting a birth cohort effect may have been associated with previously observed trends. Recent increases among non-Hispanic White individuals 50 years or older of both sexes have matched or outpaced younger age groups. Continuing increases among older individuals, particularly female individuals, may be associated with a shift in the OTC patient profile over time.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Huang reported grants from University Of Kentucky during the conduct of the study. Dr Hull reported grants from the Merck Foundation, American Cancer Society, and Eli Lilly and Company; personal fees from St. Jude Children’s Hospital and Cancer Center, AdventHealth, South Carolina Cancer Alliance, and Kentucky Rural Health Association; and nonfinancial support from the American Cancer Society outside the submitted work. Dr Deshmukh reported personal fees from Value Analytics outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Trends in the Annual Incidence Rates of Oral Tongue Cancer among Non-Hispanic White Male and Female Individuals by Onset
Incidence rates between 2001 and 2019 by early (aged <50 years) vs typical onset among males (A) and female individuals (B). aIndicates statistically significant average annual percentage change in incidence from 2001 to 2019.
Figure 2.
Figure 2.. Trends in Oral Tongue Cancer Incidence Among Non-Hispanic White Female Individuals Among Those With Early-Onset Disease (Aged <50 Years) vs Those Aged 50 to 59 Years From 2001 to 2019
aIndicates statistically significant average annual percentage change in incidence from 2001 to 2019.
Figure 3.
Figure 3.. Incidence Rate Ratios of Oral Tongue Cancer by Non-Hispanic White Birth Cohort With Joinpoint Regression Trends
aIndicates statistically significant birth cohort percentage change in rate ratio for specific Joinpoint segment.8 They different colors and shading represent the different joinpoint segments estimated by Joinpoint regression. The trends in male individuals had 2 joinpoints, creating 3 segments, and the trends in female individuals had 1 joinpoint, creating 2 segments.
Figure 4.
Figure 4.. Age-Specific Oral Tongue Cancer Incidence Trends and Projections Among Non-Hispanic White Male and Female Individuals
See this image and copyright information in PMC

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