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. 2025 Dec;57(1):2547092.
doi: 10.1080/07853890.2025.2547092. Epub 2025 Aug 19.

Incidence, mortality, and DALYs of global pharyngeal cancer: systematic analysis and projections Based on global burden of disease study 2021

Tianjiao Zhou  1   2   3 , Ying Shen  4 , Enhui Zhou  1   2   3 , Jingyu Zhang  1   2   3 , Xiaoting Wang  1   2   3 , Fan Song  1   2   3 , Lili Xiao  1   2   3 , Chen Xu  1   2   3   5 , Wen Lu  1   2   3 , Haibo Ye  4 , Kaiming Su  1   2   3 , Hongliang Yi  1   2   3 , Weijun Huang  1   2   3
Affiliations

Incidence, mortality, and DALYs of global pharyngeal cancer: systematic analysis and projections Based on global burden of disease study 2021

Tianjiao Zhou et al. Ann Med. 2025 Dec.

Abstract

Introduction: Compared to other head and neck cancers, pharyngeal cancer (PC) has poorer survival, representing a significant health burden. This study aimed to assess the burden and trends of PC at global, regional, and national levels and analyze mortality-related factors.

Methods: Data on PC, including incidence, mortality, disability-adjusted life-years (DALYs), and death-related risk factors from 1990 to 2021, were obtained from the Global Burden of Disease Study 2021. Estimated annual percentage changes (EAPCs) were calculated to assess trends.

Results: In 2021, PC incidence was 169,820, with 98,435 deaths and 2,843,781 DALYs. Age-standardized rates for incidence, death, and DALYs were 1.93, 1.13, and 32.30 per 100,000, respectively. South Asia had the highest death and DALYs rates (3.23 and 93.00). Low-middle socio-demographic index (SDI) regions showed the highest death rate (2.19) and the greatest EAPC for death rates (0.684%). A positive correlation between SDI and death rates was observed globally (R = 0.26, p < 0.05), particularly in males (R = 0.3, p < 0.05), but not in females. Males exhibited a trend toward younger ages at death by aclohol, peaking in the 35-39-year group.

Conclusion: In 2021, global PC incidence, deaths, and DALYs increased significantly, with notable regional disparities, especially in low-middle SDI regions. Alcohol-related mortality disproportionately affected younger males. Strengthening oral health resources, controlling alcohol and tobacco use are essential to reducing the global PC burden.

Keywords: Global burden of disease study; death; disability-adjusted life-years; incidence; pharyngeal cancer.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Age-standardized disease burden and estimated annual percentage change of pharyngeal cancer across 204 countries and territories from 1990 to 2021. ASIR, age-standardized incidence rate; ASDR, age-standardized death rate; DALYs, disability-adjusted life years; EAPC, estimated annual percentage change
Figure 2.
Figure 2.
Incidence burden and trends of pharyngeal cancer from 1990 to 2021 across different SDI regions, age groups, and genders. A: Incidence numbers and ASIR of pharyngeal cancer globally and across 5 SDI level regions; B: Correlation between the ASIR of pharyngeal cancer and SDI index across 204 countries and territories globally by gender. R, the correlation coefficient; C: Incidence burden of pharyngeal cancer across different age groups (5 year intervals) by gender in 2021; D: Age-related incidence ratio of pharyngeal cancer between 2000 and 2021 in 204 countries and territories. Points filled by grey color represent an annual change less than 0. Different colors indicate 7 GBD super-regions. Point size represents the absolute annual change of the age-related incidence rate from 2000 to 2021. ASIR, age-standardized incidence rate.
Figure 3.
Figure 3.
Deaths burden and trends of pharyngeal cancer from 1990 to 2021 across different SDI regions, age groups, and genders. A: Deaths numbers and ASDR of pharyngeal cancer globally and across 5 SDI level regions; B: Correlation between the ASDR of pharyngeal cancer and SDI index across 204 countries and territories globally by gender. R, the correlation coefficient; C: Deaths burden of pharyngeal cancer across different age groups (5 year intervals) by gender in 2021; D: Age-related deaths ratio of pharyngeal cancer between 2000 and 2021 in 204 countries and territories. Points filled by grey color represent an annual change less than 0. Different colors indicate 7 GBD super-regions. Point size represents the absolute annual change of the age-related Deaths rate from 2000 to 2021. ASDR, age-standardized deaths rate.
Figure 4.
Figure 4.
DALYs Burden and trends of pharyngeal cancer from 1990 to 2021 across different SDI regions, age groups, and genders. A: DALYs and age-standardized DALYs rate of pharyngeal cancer globally and across 5 SDI level regions; B: Correlation between the age-standardized DALYs rate of pharyngeal cancer and SDI index across 204 countries and territories globally by gender. R, the correlation coefficient; C: DALYs burden of pharyngeal cancer across different age groups (5 year intervals) by gender in 2021; D: Age-related DALYs ratio of pharyngeal cancer between 2000 and 2021 in 204 countries and territories. Points filled by grey color represent an annual change less than 0. Different colors indicate 7 GBD super-regions. Point size represents the absolute annual change of the Age-related DALYs rate from 2000 to 2021. DALYs, disability-adjusted life years.
Figure 5.
Figure 5.
Frontier and health inequality analysis of ASIR, ASDR, and age-standardized DALYs rates for pharyngeal cancer based on SDI in 204 countries and territories. A. Frontier curves of ASIR, ASDR, and age-standardized DALYs rates for pharyngeal cancer, 1990–2021. B. Frontier curves of ASIR, ASDR, and age-standardized DALYs rates for pharyngeal cancer based on 2021 SDI. C. Slope index of inequality of ASIR, ASDR, and age-standardized DALYs rates for pharyngeal cancer for 1990 and 2021. D. Concentration index of ASIR, ASDR, and age-standardized DALYs rates for pharyngeal cancer for 1990 and 2021. ASIR: Age-standardized incidence rate; ASDR: Age-standardized death rate; DALYs: Disability-adjusted life years; SII: Slope index of inequality
Figure 6.
Figure 6.
Risk factors associated with mortality and prediction of disease burden for pharyngeal cancer. A. Bayesian age-period-cohort projections for pharyngeal cancer from 2022 to 2050. B. Risk factors fordeaths by age groups associated with smoking and alcohol for global pharyngeal cancer in 2021. C. Risk factors for deaths by age groups associated with smoking and alcohol use for pharyngeal cancer across SDI regions and genders. BAPC: Bayesian Age-Period-Cohort
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