title: Trends in cancer of the head and neck in the elderly in Denmark, 1980-2012.
abstract: BACKGROUND
  Squamous cell carcinoma of the head and neck (HNSCC) comprises a variety of malignant tumors. Due to the rarity of each individual malignant entity, knowledge of epidemiological changes and trends over time may be derived from data compiled in regional and national registries. This study analyzed the development in incidence rates and mortality in elderly HNSCC patients in Denmark between 1980 and 2012 with specific attention to compliance to radiotherapy, the main treatment modality of HNSCC in Denmark.
  
  
  METHODS
  HNSCC consisting of more than 25 patients per year over the age of 70 years were analyzed. This included cancer of the oral cavity defined as ICD-codes C00.3-4, C02-04, C05.0, C06; oropharynx as C01, C05.1-9, C09-10; and larynx as C32 recorded in the NORDCAN database. Additional data from the DAHANCA database was added to assess differences in compliance to treatment between younger and older patient groups.
  
  
  RESULTS
  HNSCC was predominant in younger patients. Only 17% were older than 70 years. The median age was 60 years. Generally, incidence rates rose for cancer of the oral cavity and oropharynx between 1980 and 2012 and stabilized for laryngeal cancer. Mortality rates had a shallower increase, especially in younger age groups, which translated into improved age-specific survival rates. Compliance to radiotherapy was high for all age groups. Failure to receive at least 60 Gy during radical radiation treatment was 2.3% despite a significant increase in patients with poor WHO performance status over time.
  
  
  CONCLUSIONS
  HNSCC is a rare disease in patients above 70 years accounting for only 17% of all HNSCC patients. Incidence rates increased over time, but age-specific survival rates improved, especially in younger patients. Failure rates to comply with radiation treatment, however, were low in both young and elderly patients.
authors.affiliation: a Department of Oncology , Odense University Hospital, Institute of Clinical Research, University of Southern Denmark , Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Johansen
authors.affiliation: a Department of Oncology , Odense University Hospital, Institute of Clinical Research, University of Southern Denmark , Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Grau Eriksen
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000453:epidemiology; D008297:Male; D009062:Mouth Neoplasms / Q000453:epidemiology; D010610:Pharyngeal Neoplasms / Q000453:epidemiology; D012042:Registries; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate