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Program Number: B350
Session Name: Poster Session

Site-Specific Trends in Survival, Incidence, and Treatment of Head and Neck Cancer: A 15-year SEER Database Analysis

Christopher Stewart¹; JB Eyring²; Joseph Hanny¹; Grant Sanders¹; Alex Otto³; Randall Hansen³; Kent McIntire³; ¹Kansas City University; ²University of Utah Department of Otolaryngology- Head and Neck Surgery; ³Freeman Health System Department of Otolaryngology

Introduction: Head and neck cancer treatment and outcomes vary based on location, staging, and evolving guidelines. This study aimed to analyze the site-specific trends in survival, cancer location, and treatment methods for head and neck cancer since the turn of the century. 

Methods: Data were retrieved from the SEER database, providing a large and diverse national sample. Incidence, clinical stage, diagnosis, and 5-year survival rate of malignant tumors (N=262,426) diagnosed from 2000-2015 and followed for at least 5 years were included. Anatomical cancer regions included salivary gland, larynx, oral cavity, lip, tongue, nasopharynx, oropharynx, hypopharynx. Treatment groups included surgery, radiation, surgery/radiation, chemotherapy/radiation, and surgery/chemotherapy/radiation. Chi-square and linear time-series regression analyses were performed to assess changes in incidence, 5-year survival, and treatment methods over time, with cancer stage as a control. All analyses were conducted using SAS Studio version 9.4.

Results: From 2000-2015, 5-year survival increased in the hypopharynx (8.5% increase, p<.001), tongue (8.5% increase, p<.001), oropharynx (8.0% increase, p<.01), and oral cavity (4.4% increase, p<.05). No significant changes were seen in the salivary gland (p>.05) and nasopharynx (p>.05). Regarding treatment, there was a decrease in the proportion treated with a combination of surgery/radiation (11.0% decrease, p<.001) and radiation alone (7.6% decrease, p<.001). In contrast, an increase was seen in chemotherapy/radiation (16.9% increase, p<.001) treatment. There was an overall incidence increase in the proportion of cases in the tongue (12.2% increase, p<.001) whereas decreases were seen in the larynx (10.0% decrease, p<.001). 

Conclusion: Five-year survival increased in almost all regions of the head and neck except the lip and nasopharynx with oropharyngeal cancer showing the largest improvement. Surgery remained a leading treatment for head and neck cancer over this period while combination therapies increasingly favored chemotherapy with radiation, alongside a notable decline in surgery with radiation. This shift may reflect advancements in combination therapies or optimized treatment strategies for individual patients. Additionally, incidence of tongue cancer has increased, which may be due to behavioral, environmental, or diagnostic shifts. These findings highlight areas for targeted research on treatment efficacy by cancer site and underscore the importance of evolving treatment combinations to enhance patient outcomes.

 

 

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