Oropharyngeal cancer incidence trends: diminishing racial disparities
The aim of this article is to evaluate oral cavity/pharyngeal cancer (OCPC) trends that may reflect changes in cigarette smoking, alcohol consumption, and human papillomavirus (HPV) infection.
We used Surveillance, Epidemiology, and End Results program data for 58,204 cases diagnosed during 1977–2007 to classify if squamous cell carcinomas of the OCP by anatomic site are potentially HPV-related.
OCPC rates among men peaked during 1982–1986 before declining, most rapidly (46%) among blacks. Rates decreased least rapidly among white males while declining at intermediate paces among other ethnic groups (Asian/Pacific Islanders and Hispanics) and females. Among the men during the recent 16-year time period, the annual percent change for HPV-unrelated sites was much steeper [−6.0% (95% CI = −7.2 to −4.9)] among blacks than whites [−2.5% (95% CI = −2.9 to −2.1)]; for HPV-related sites, it was −1.7% (95% CI = −2.6 to −0.7) among blacks, in striking contrast to +3.3% (95% CI = 2.5–4.0) among whites. HPV-related rates rose rapidly among the white men born since the mid-1940s, tripling among those aged 25–44 and recently surpassing the black male rate. Relative survival rates rose over the study period due to improvements among HPV-related cases.
The OCPC decreases found among all the race/sex groups reflect reductions in smoking prevalence and alcohol consumption. Rising HPV-related cancers among white men may reflect changes in sexual practices since the mid-1960s.
KeywordsOropharyngeal cancer Human papillomavirus (HPV) Descriptive epidemiology Incidence Health disparities
This study was supported by the Intramural Program of the Division of Cancer Epidemiology and Genetics, the National Cancer Institute (NCI), and National Institutes of Health.
- 1.Altekruse SF, Kosary CL, Krapcho M, et al (2010) SEER Cancer Statistics Review, 1975–2007. National Cancer Institute. Bethesda, MD, http://www.seer.cancer.gov/csr/1975_2006, based on November 2009 SEER data submission, posted to the SEER website, 2010
- 6.IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 90, Human Papillomaviruses, World Health Organization, International Agency for Research on Cancer, Lyon, France, 2007Google Scholar
- 15.Auluck A, Hislop G, Bajdik C, et al (2010) Trends in oropharyngeal and oral cavity cancer incidence of human papillomavirus (HPV)-related and HPV-unrelated sites in a multicultural population: the British Columbia experience. CancerGoogle Scholar
- 16.Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 9 Regs Limited-Use, Nov 2008 Sub (1973–2007) <katrina/Rita Population Adjustment>— Linked to County Attributes—Total US, 1969–2007 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2010, based on the November 2009 submission
- 17.Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence—SEER 13 Regs Limited-Use, Nov 2009 Sub (1992–2007) <Katrina/Rita Population Adjustment>— Linked to County Attributes—Total US, 1969–2007 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2010, based on the November 2009 submission
- 18.Fritz A, Percy C, Jack K et al (2000) International Classification of Diseases for Oncology, 3rd edition (ICD-O-3). World Health Organization, GenevaGoogle Scholar
- 19.Surveillance Research Program, National Cancer Institute, SEER*Stat software SEER*Stat. 2009 3/2/2010; 6.6.1:Available from: www.seer.cancer.gov/seerstat/
- 22.National Center for Health Statistics. Health, United States, 2009: With Special Freature on Medical Technology. Hyattsville, Maryland. 2010Google Scholar
- 23.National Center for Health Statistics. Health, United States, 2007. Hyattsville, Maryland. 2008Google Scholar
- 24.National Center for Health Statistics. Health, United States, 2005. Hyattsville, Maryland. 2006Google Scholar
- 25.National Center for Health Statistics. Health, United States, 2002. Hyattsville, Maryland. 2003Google Scholar
- 26.LaVallee RA, Williams GD, Yi H (2009) Surveillance Report #87: Apparent Per Capita Alcohol Consumption: National, State, and Regional Trends, 1970–2007. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism, Division of Epidemiology and Prevention Research. Alcohol Epidemiologic Data SystemGoogle Scholar
- 27.Nephew TM, Yi H, Williams GD, Stinson FS, Dufour MC (2004) US Alcohol Epidemiologic Data Reference Manual, Vol. 1, 4th ed. US Apparent Consumption of Alcoholic Beverages Based on State Sales, Taxation, or Receipt Data. Washington, DC: NIAAA. NIH. Alcohol Epidemiologic Data SystemGoogle Scholar
- 28.Hyman M, Zimmerman M, Gurioli C, Helrich A (1980) Drinkers, drinking and alcohol-related mortality and hospitalizations: a statistical compendium. New Brunswik, NJGoogle Scholar
- 38.Kingma DW, Allen RA, Moore W et al (2010) HPV genotype distribution in oral and oropharyngeal squamous cell carcinoma using seven in vitro amplification assays. Anitcancer Res 30:5099–5104Google Scholar