title: Trends of head and neck cancers in urban and rural India.
abstract: BACKGROUND
  The sub-site predilection of head and neck squamous cell carcinoma (HNSCC) reflects the risk profile of a community and there are suggestions that these are changing over time.
  
  
  OBJECTIVE
  To determine the change in head and neck cancer in rural and urban populations in India.
  
  
  METHODS
  Cancer registry data of an urban and a rural population were reviewed over a period of 13 and 11 years, respectively. Age adjusted rates (AAR) and age specific incidence rates were used for data analysis.
  
  
  RESULTS
  Oral cancers formed the majority of the head and neck cancers with a predilection for tongue, except in rural males, in whom the pharynx was the predominant sub-site. Overall there was a reduction in the incidence of HNSCC, which was more pronounced in urban females and rural males (p< .001). Among the sub-sites, oral cavity cancers showed a decreasing trend in urban females (p< .01) and rural males (p< .01). However, the trend was towards increase of incidence of tongue cancers. Pharyngeal cancer showed reduction in urban females (p< .01), whereas it increased in rural females. The recent increase in incidence of young adults with HNSCC reported in developed countries was not observed.
  
  
  CONCLUSIONS
  Overall, incidence of HNSCC is reducing. This may be attributed to the decreased prevalence of tobacco use. The increase in incidence of tongue cancer may suggest factors other than tobacco and alcohol in its genesis.
authors.affiliation: Head and Neck Institute, Amrita Institute of Medical Sciences and Research Center (Deemed University) Cochin, Kerala, India-682026. gangadharanp@aimshospital.org
authors.forename: J Kalavathy
authors.initials: JK
authors.lastname: Elango
authors.forename: P
authors.initials: P
authors.lastname: Gangadharan
authors.forename: S
authors.initials: S
authors.lastname: Sumithra
authors.forename: M A
authors.initials: MA
authors.lastname: Kuriakose
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D010610:Pharyngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012424:Rural Population; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects*; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D014505:Urban Population