Incidence trends of head and neck cancer in the provinces of Girona and Tarragona (1994-2018): a population-based study

Abstract

Background: Head and neck cancer (HNC) appears to be decreasing in incidence in developed countries, with potential changes in aetiology proposed. This study aims to provide a regional approach of HNC incidence trends overall and by subsites, which may afford knowledge for preventative measures and leveraging resources in order to reduce the burden of HNCs. Objectives: To determine the trends in incidence of HNC, both overall and by anatomical subsites based on the International Classification of Diseases for Oncology, 3rd edition (ICD-O-3) topographic codes, while also discerning variations between sexes between 1994 and 2018 in the population of the provinces of Girona and Tarragona. Design: A population-based retrospective observational cohort study conducted between December 2022 and January 2024. Methods: 7966 cases of patients diagnosed with primary HNC from 1994 to 2018 were identified from the Cancer Registry of Girona (CRG) and Cancer Registry of Tarragona (CRT) database. Incidence has been estimated as Crude Rate (CR), Age-Standardized to the European population Incidence Rate (ASIRE), Age-Standardized to the World population Incidence Rate (ASIRW) and Age-specific rates (ASR). Incidence trends for overall HNC and by subsite were calculated subsequently through the Annual Percent Change (APC) of ASIR, expressed as a percentage increase or decrease with a 95% confidence interval (95% CI). Results: A significant decrease in incidence, with an APC of -1.83, was observed between 1994 and 2018 in overall HNC. Incidence also exhibited a decline in lip, hypopharyngeal, laryngeal and salivary glands cancers. Among men, a significant decrease in incidence was observed between 1994 and 2018 in overall HNC, lip, oral cavity, nasopharyngeal, hypopharyngeal, laryngeal and salivary glands cancers. In women, a significant increase in incidence was identified for overall HNC, as well as for oral cavity, oropharyngeal, hypopharyngeal and laryngeal cancers, during the same period. Conclusions: A significant decrease in the incidence of overall HNC, along with cancers affecting the lip, hypopharynx, larynx, and salivary glands, has been observed in the provinces of Girona and Tarragona from 1998 to 2018. During this period, the general trend observed among men is declining, whilst the general trend observed in women is rising