Trends in incidence and prognosis for head and neck cancer in the United States: A site‐specific analysis of the SEER database

Abstract Despite recent advances in the diagnosis and treatment of head and neck cancer, there has been little evidence of improvement in 5‐year survival rates over the last few decades. To determine more accurate trends in site‐specific outcomes as opposed to a more general overview of head and neck cancer patients, we analyzed the site‐specific data collected in the Surveillance, Epidemiology, and End Results—SEER Public‐Use Database 1973–1999. Based on the selection criteria, 96,232 cases were evaluated for trend analysis in incidence, clinical stage, treatment and 5‐year survival. During the period 1973–1999, site‐specific incidence rates for head and neck cancer changed significantly. Site‐specific analysis of survival from 1974–1997 showed significant improvements in 5‐year survival rates for cancers of the nasopharynx, oropharynx and hypopharynx (38.1% to 56.7% for nasopharynx, p < 0.001; 36.3% to 49.1% for oropharynx, p = 0.001 and 28.3% to 33.3% for hypopharynx, p = 0.015). The prognosis for early‐stage salivary gland cancer during 1983–1997 and late‐stage larynx cancer during 1974–1997 also demonstrated improvement (82.7% to 88.5%, p = 0.012 and 22.2% to 38.3%, p = 0.013, respectively). On the other hand, the prognosis for regional stage oral cavity cancer as well as early‐stage larynx cancer patients declined during 1983–1997 (49.2% to 43.8%, p = 0.032 and 82.3% to 74.3%, p = 0.002, respectively). Site‐specific changes in treatment and staging were also noted. Site‐specific analysis allows for a more accurate description of incidence, staging, treatment, and prognostic trends for head and neck cancer. © 2004 Wiley‐Liss, Inc.