Abstract

The emergence of HPV-positive oropharyngeal cancer (OPC) and evolving tobacco use patterns have changed the landscape of head and neck cancer epidemiology internationally. We investigated updated trends in OPC incidence worldwide.We analyzed cancer incidence data during 1993-2012 from 42 countries using the Cancer Incidence in Five Continents database Volumes V-XI. Trends in OPC incidence were compared to oral cavity cancers (OCC) and lung squamous cell carcinoma (SCC) using log-linear regression and age-period-cohort modeling.156,567 OPC, 146,693 OCC, and 621,947 lung SCC cases were included. OPC incidence significantly increased in 19 and 23 countries in men and women, respectively. In countries with increasing male OPC incidence, all but one had significantly decreasing lung SCC incidence, and all but two had decreasing or non-significant net drifts for OCC. Increased OPC incidence was observed both in middle (40-59?years old) and older (=60?years old) age male cohorts, with strong non-linear birth cohort effects. In 20 countries where OPC incidence increased for women and age-period-cohort analysis was possible, 13 had negative or non-significant lung SCC net drifts, including 4 with significantly higher OPC net drift increases vs both lung SCC and OCC.Increasing OPC incidence is seen among an expanding array of countries worldwide. In men, increased OPC is extending to older age groups, likely driven by HPV-related birth-cohort effects. In women, more diverse patterns were observed, suggesting complex interplay of risks factors varying by country, including several countries where female OPC increases may be driven by HPV.

View details for DOI 10.1093/jnci/djad169

View details for PubMedID 37603716