Background and Material
Changing patterns of alcohol and tobacco consumption and human papillomavirus (HPV) infection have affected the epidemiology of head & neck cancers. The aim of the study was to examine 20-year trends in the incidence and survival of head & neck cancers in Estonia by site, sex, morphology and stage.
Methods
Data on all adult cases of invasive head & neck cancers diagnosed in Estonia in 1996–2016 were obtained from the population-based cancer registry. TNM stage was available for 2010–2016. Incidence trends were modelled with joinpoint regression and five-year relative survival ratios (RSR) were calculated.
Results
A total of 6769 cases were included, 64% among men. We observed significant decline in the incidence of lip and laryngeal cancer and significant increase in the incidence of hypopharyngeal and oropharyngeal cancers. Over 60% of mouth & pharyngeal cancers were diagnosed at stage IV.
Age-standardized five-year RSR for mouth & pharyngeal cancer increased significantly over the study period, from 21% in 1996–2002 to 33% in 2010–2016. The largest survival increases were seen for cancers of oral cavity (44% in 2010–2016), tongue (41%) and larynx (63%), while modest changes were seen for oropharynx (24%) and hypopharynx (17%). The latest five-year RSR was 90% for thyroid cancers (99% for papillary carcinoma). Large female survival advantage was seen for most sites.
Conclusions
The observed trends suggest an emerging role of HPV infection in combination with traditional risk factors in the development of head & neck cancers in Estonia. Efforts targeting health behavior, HPV vaccination and earlier diagnosis are crucial for reducing mortality from these cancers.

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This is a list of supplementary files associated with this preprint. Click to download.
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Posted 08 Dec, 2020
Posted 08 Dec, 2020
Background and Material
Changing patterns of alcohol and tobacco consumption and human papillomavirus (HPV) infection have affected the epidemiology of head & neck cancers. The aim of the study was to examine 20-year trends in the incidence and survival of head & neck cancers in Estonia by site, sex, morphology and stage.
Methods
Data on all adult cases of invasive head & neck cancers diagnosed in Estonia in 1996–2016 were obtained from the population-based cancer registry. TNM stage was available for 2010–2016. Incidence trends were modelled with joinpoint regression and five-year relative survival ratios (RSR) were calculated.
Results
A total of 6769 cases were included, 64% among men. We observed significant decline in the incidence of lip and laryngeal cancer and significant increase in the incidence of hypopharyngeal and oropharyngeal cancers. Over 60% of mouth & pharyngeal cancers were diagnosed at stage IV.
Age-standardized five-year RSR for mouth & pharyngeal cancer increased significantly over the study period, from 21% in 1996–2002 to 33% in 2010–2016. The largest survival increases were seen for cancers of oral cavity (44% in 2010–2016), tongue (41%) and larynx (63%), while modest changes were seen for oropharynx (24%) and hypopharynx (17%). The latest five-year RSR was 90% for thyroid cancers (99% for papillary carcinoma). Large female survival advantage was seen for most sites.
Conclusions
The observed trends suggest an emerging role of HPV infection in combination with traditional risk factors in the development of head & neck cancers in Estonia. Efforts targeting health behavior, HPV vaccination and earlier diagnosis are crucial for reducing mortality from these cancers.

Figure 1

Figure 1

Figure 2

Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
Loading...