title: Trends in incidence and prognosis for head and neck cancer in the United States: a site-specific analysis of the SEER database.
abstract: Despite recent advances in the diagnosis and treatment of head and neck cancer, there has been little evidence of improvement in 5-year survival rates over the last few decades. To determine more accurate trends in site-specific outcomes as opposed to a more general overview of head and neck cancer patients, we analyzed the site-specific data collected in the Surveillance, Epidemiology, and End Results-SEER Public-Use Database 1973-1999. Based on the selection criteria, 96,232 cases were evaluated for trend analysis in incidence, clinical stage, treatment and 5-year survival. During the period 1973-1999, site-specific incidence rates for head and neck cancer changed significantly. Site-specific analysis of survival from 1974-1997 showed significant improvements in 5-year survival rates for cancers of the nasopharynx, oropharynx and hypopharynx (38.1% to 56.7% for nasopharynx, p < 0.001; 36.3% to 49.1% for oropharynx, p = 0.001 and 28.3% to 33.3% for hypopharynx, p = 0.015). The prognosis for early-stage salivary gland cancer during 1983-1997 and late-stage larynx cancer during 1974-1997 also demonstrated improvement (82.7% to 88.5%, p = 0.012 and 22.2% to 38.3%, p = 0.013, respectively). On the other hand, the prognosis for regional stage oral cavity cancer as well as early-stage larynx cancer patients declined during 1983-1997 (49.2% to 43.8%, p = 0.032 and 82.3% to 74.3%, p = 0.002, respectively). Site-specific changes in treatment and staging were also noted. Site-specific analysis allows for a more accurate description of incidence, staging, treatment, and prognostic trends for head and neck cancer.
authors.affiliation: Head and Neck and Otorhinolaryngology Department, Centro de Tratamento e Pesquisa, Hospital do Cancer A.C. Camargo, São Paulo, Brazil.
authors.forename: André Lopes
authors.initials: AL
authors.lastname: Carvalho
authors.forename: Inês Nobuko
authors.initials: IN
authors.lastname: Nishimoto
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Califano
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D019992:Databases as Topic; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009369:Neoplasms / Q000378:metabolism; D011379:Prognosis; D012042:Registries; D018426:SEER Program; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome