title: Changes in survival in head and neck cancers in the late 20th and early 21st century: a period analysis.
abstract: BACKGROUND
  Therapy for head and neck cancers has evolved over the past decade, but few detailed analyses of recent developments in survival on the population level have been published.
  
  
  METHODS
  We use period analysis and modeled period analysis to disclose recent trends in survival in patients with head and neck cancer. Data are derived from the Surveillance, Epidemiology, and End Results limited-use database.
  
  
  RESULTS
  A major, statistically significant improvement in survival was observed, with the overall 5-year relative survival rate going from 54.7% in 1992-1996 to 65.9% in 2002-2006. Subgroup analysis showed improvement in cancers of the oral cavity, tongue, tonsils, and nasopharynx, with the greatest improvements observed in tonsillar carcinoma (+22.2 percentage points) and carcinoma of the tongue (+14.4 percentage points). Further analysis of survival for oral cavity, tonsillar, and tongue carcinoma revealed improvements in survival at each stage and across all age groups except for patients aged ≥ 75 years, with the greatest improvement occurring in locally advanced disease and in patients aged 55-64 years for carcinoma of the tongue and tonsils and those aged 15-44 years for oral cavity cancers.
  
  
  CONCLUSIONS
  Survival has substantially improved for head and neck cancer patients over the past decade. The greatest improvement was seen in tonsillar and tongue cancers.
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. pultedi@umdnj.edu
authors.forename: Dianne
authors.initials: D
authors.lastname: Pulte
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000209:etiology / Q000401:mortality* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D018426:SEER Program; D015996:Survival Rate; D013997:Time Factors
references.citation: Cancer. 1995 Nov 15;76(10):1687-8
references.pmid: 8625034
references.citation: Int J Cancer. 2006 Dec 1;119(11):2620-3
references.pmid: 16991119
references.citation: BMC Cancer. 2006 Jan 31;6:28
references.pmid: 16448551
references.citation: Int J Cancer. 2009 Nov 1;125(9):2159-65
references.pmid: 19569190
references.citation: Int J Cancer. 2005 May 1;114(5):806-16
references.pmid: 15609302
references.citation: Int J Epidemiol. 2002 Apr;31(2):456-62
references.pmid: 11980816
references.citation: Cancer. 1996 Nov 1;78(9):2004-10
references.pmid: 8909323
references.citation: J Clin Oncol. 1998 Apr;16(4):1310-7
references.pmid: 9552031
references.citation: Head Neck. 1997 Oct;19(7):567-75
references.pmid: 9323144
references.citation: Natl Vital Stat Rep. 2002 Dec 19;51(3):1-38
references.pmid: 12583542
references.citation: J Clin Oncol. 2002 Feb 1;20(3):826-32
references.pmid: 11821467
references.citation: J Adolesc Health. 2008 Oct;43(4 Suppl):S52-60
references.pmid: 18809146
references.citation: Am J Epidemiol. 2006 Oct 1;164(7):689-96
references.pmid: 16840519
references.citation: J Natl Cancer Inst. 1999 Dec 15;91(24):2081-6
references.pmid: 10601378
references.citation: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references.pmid: 19474385
references.citation: Cancer. 2000 Feb 15;88(4):876-83
references.pmid: 10679658
references.citation: Natl Cancer Inst Monogr. 1961 Sep;6:101-21
references.pmid: 13889176
references.citation: Lancet. 2000 Mar 18;355(9208):949-55
references.pmid: 10768432