Head and neck cancer trends in Denmark: A nationwide, 40-Year data analysis

BACKGROUND AND PURPOSE: Head and neck cancers (HNCs) encompass various malignancies with variation in anatomical site, histology, and survival outcomes. This study aims to describe HNC incidence and survival trends in Denmark from 1980 to 2021.

PATIENTS/MATERIAL AND METHODS: This retrospective, cohort study used data from the Danish Cancer Registry and the Central Population Register to include all HNC cases in the upper aerodigestive tract from 1980 to 2021. Incidence rates were age-adjusted and survival analyzed as relative survival rates compared to the general population. Average Annual Percent Change (AAPC) in incidence was calculated using linear regression models.

RESULTS: A total of 36,626 HNC cases were included. The age-adjusted incidence rate (AAIR) increased significantly from 7.1 in 1980 to 12.5 per 100,000 in 2021. From 2015 to 2021, oropharyngeal cancer was the most common HNC. Further, oropharyngeal cancer demonstrated the highest 5-year relative survival of 70.1 % [95 % CI: 67.9-72.4]. Hypopharyngeal cancer had the lowest survival (26.8 % [95 % CI: 25.1 to 28.7]). Overall, the 5-year relative survival improved during the study period from 46.9 % [95 % CI: 44.7-49.2] in 1980-1984 to 65.2 % [95 % CI: 63.8 to 66.6] in 2015-2019.

INTERPRETATION: Our study showed a continued increase in incidence for HNC alongside an improvement in survival. The survival varied notably across different tumor subsite. Continued research is essential to address these variations and improve outcomes across cancer subsites. Exploring opportunities for treatment de-escalation to mitigate the toxicity associated with current therapies is essential to optimizing long-term quality of life for survivors.