title: A 20-year retrospective study of tonsil cancer incidence and survival trends in South East England: 1987-2006.
abstract: BACKGROUND
  There has been an increasing incidence of tonsil cancer worldwide. Documenting these changes is crucial to cancer prevention and control measures, resource allocation and understanding disease aetiology.
  
  
  OBJECTIVE
  To analyse the changing epidemiology of tonsil cancer in South East England over a 20-year period between 1987 and 2006.
  
  
  METHODS
  A retrospective, quantitative study using secondary anonymised data obtained from the Thames Cancer Registry, London. Data were analysed using spss v.17 and survival analyses with Kaplan-Meier and Cox regression.
  
  
  METHODS
  This study was conducted in South East of England comprising London, Kent, Surrey and Sussex counties with an average population of 12 million. This population increased from 10.7 to 11.8 million (a 10% increase) between 1987 and 2006.
  
  
  METHODS
  All patients with tonsil cancer in South East England registered with the Thames Cancer Registry (ICD-10 code C09) between 1987 and 2006. A total of 1794 patients' data were analysed. Ethical Considerations: Ethical approval was granted by the Kent Research Ethics Committee.
  
  
  METHODS
  Data were analysed for demographic trends including gender, age at diagnosis, yearly incidence and survival.
  
  
  RESULTS
  Tonsil cancer incidence has increased significantly from 0.60 to 1.45 per 100,000 in the 20 years (P < 0.001). This increase is mainly amongst men and age groups 40-59 years with a significant reduction in age at diagnosis by 2 years from 61.6 years in the first decade to 59.6 years in the second decade (P < 0.001). Survival was worse in men, older age groups and in the presence of synchronous tumours (P < 0.001). There has been a statistically significant increase in median survival times from tonsil cancer by about 3 years from 2.7 years in the first decade to 5.7 years in the second decade of this study (P < 0.001).
  
  
  CONCLUSIONS
  Tonsil cancer incidence has increased in the 20 years of this study in South East England, especially amongst men and age groups 40-59 years. There has also been significant reduction in the mean age at diagnosis and an increase in median survival times for tonsil cancer. Further studies are needed to explain these trends.
authors.affiliation: Department of Otolaryngology, Russells Hall Hospital, Dudley, West Midlands UK. dejolaleye@yahoo.com
authors.forename: O
authors.initials: O
authors.lastname: Olaleye
authors.forename: R
authors.initials: R
authors.lastname: Moorthy
authors.forename: O
authors.initials: O
authors.lastname: Lyne
authors.forename: M
authors.initials: M
authors.lastname: Black
authors.forename: D
authors.initials: D
authors.lastname: Mitchell
authors.forename: J
authors.initials: J
authors.lastname: Wiseberg
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014067:Tonsillar Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult