Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Background: The literature surrounding oral cavity cancers has shown decreasing rates of these mucosal malignancies. However, anecdotal experiences seem to suggest otherwise. Here, we use the Surveillance, Epidemiology, and End Results (SEER) database to present an updated assessment of oral cavity cancer rates in the United States.
Materials and Methods: A retrospective analysis was conducting using the SEER database. All cases of oral cavity cancer were identified from the November 2023 SEER submission of 8 registries (1975 to 2021) by ICD codes. Incidence rate and survival data were used to analyze the most recent epidemiologic trends.
Results: There were 43,206 cases of oral cavity cancer recorded from the SEER database with mean ± SD age at diagnosis of 61.9 ± 14.4 years. Chi square analysis found a statistically significant association between age at diagnosis and cancer incidence (χ2 = 1037.49, p < .001). Incidence rate for patients 55 and older increased by 18.8% from 2005–09 to 2015–19 (p = .033). Joinpoint log-linear regression analysis demonstrated increasing annual percent changes (APC) since the early 2000s for ages 55 and older as high as 4.13% (p < .001). APCs for patients aged 25–29, 30–34, and 35–39 have also steadily increased since 1975 by 1.34% (p = .003), 1.41% (p < .001), and .5% (p = .08) respectively while APCs for patients aged 40–44, 45–49, and 50–54 have steadily decreased by .65% (p = .018), 1.22% (p < .001), and 1.10% (p < .001). Cox regression modeling demonstrated improved survival over time with a 5% per year decrease in hazard of death (HR=.950, 95% CI = [.944, .957], p < .001). Kaplan Meier analysis demonstrated improved five-year survival since 2000 from 51.7% to 69.4% (χ2 = 294.42, p < .001). Stratified age modeling demonstrated hazard of death increased by over 2-fold for patients over 25 and 3-fold for patients over 75. The overall incidence rate increased by 17.2% from 6.09 to 7.14 per 100,000 from 2005–2009 to 2015–2019 (p = .358).
Conclusions: Our SEER database study captures the nuances of changing incidence rates of oral cavity cancer. The incidence rate is increasing in certain age groups, especially patients aged 55 and above. We also show that there are significant differences in incident rates between various age groups. Overall prognosis for oral cavity cancer has also continued to improve with higher 5-year-survival rates when compared to older analyses of national data.