(B-007) Updated Trends in incidence, prevalence, and survival in patients with Head and Neck Squamous Cell Carcinoma in the United States

Background: Approximately 90% of all Head and Neck Cancer (HNC) tumors are categorized as squamous cell carcinomas (HNSCC). There is variation in the global incidence of HNSCC, which reflects the differences in the distribution of known risk factors associated with survival, and epidemiology has changed drastically in the past decade in the US. Updated estimates of HNSCC in the US are needed.

Objectives: To calculate the most recent epidemiologic estimates of HNSCC in the US.

Methods: This cross-sectional epidemiological analysis used data from the US population-based cancer registries (SEER-22) to identify patients ≥18 years diagnosed with HNSCC between 2015 and 2021 based on International Classification of Disease for Oncology, 3rd edition site and morphology codes. The main outcomes and measures were annual age-adjusted HNSCC incidence per 100 000 persons; annual age-adjusted limited-duration prevalence per 100 000 persons; relative estimates of period survival rates.

Results: Among the included patients with HNC, squamous cell neoplasm was the predominant histology (99.8%). The incidence of HNSCC decreased from 9.45 per 100,000 in 2015 to 8.54 per 100,000 in 2021.​ Similarly, the incidence of Distant Stage IV HNSCC decreased from 1.7 per 100,000 in 2015 to 1.2 per 100,000 in 2021. In each year, the highest incidence of HNSCC was recorded among men ≥65 years. The limited-duration prevalence of HNSCC increased from 52.95 cases per 100,000 persons in 2015 to 64.87 cases per 100,000 persons in 2021.​ From 2015 to 2021, prevalence increased in both men and women with men exhibiting higher prevalence for each year assessed. Similarly, prevalence rose in patients ≥65 years and those < 65 years during the same period. The 5-year survival rates estimated in 2020 in all HNSCC cases and those with Distant Stage IV HNSCC were 51.6% and 17.4%, respectively. For Distant Stage IV HNSCC, the 5-year survival rate is comparable to the 17.6% estimate from 2015. Among patients with Distant Stage IV disease, survival rates were consistently lower for patients ≥65years, and male patients for each of the first five years. By race, the declining trend in incidence between 2015 and 2021 was most pronounced in non-Hispanic Blacks (Annual Percent Change: -10.49 [95% CI: -16.72 to -3.81]).

Conclusions: The findings of this analysis suggest that although the incidence of metastatic HNSCC decreased between 2015 and 2021, it remained consistently higher among older male patients (≥65 years) when compared to those aged < 65 years, whereas the prevalence of HNSCC increased during the same period. The 5-year survival rates for Distant Stage IV HNSCC remained unchanged for the 2015 and 2020 period estimated years, indicating the persisting unmet needs for patients with metastatic HNSCC.