Oropharyngeal cancer incidence trends: diminishing racial disparities.

ABSTRACT

OBJECTIVE: The aim of this article is to evaluate oral cavity/pharyngeal cancer (OCPC) trends that may reflect changes in cigarette smoking, alcohol consumption, and human papillomavirus (HPV) infection. METHODS: We used Surveillance, Epidemiology, and End Results program data for 58,204 cases diagnosed during 1977-2007 to classify if squamous cell carcinomas of the OCP by anatomic site are potentially HPV-related. RESULTS: OCPC rates among men peaked during 1982-1986 before declining, most rapidly (46%) among blacks. Rates decreased least rapidly among white males while declining at intermediate paces among other ethnic groups (Asian/Pacific Islanders and Hispanics) and females. Among the men during the recent 16-year time period, the annual percent change for HPV-unrelated sites was much steeper [-6.0% (95% CI = -7.2 to -4.9)] among blacks than whites [-2.5% (95% CI = -2.9 to -2.1)]; for HPV-related sites, it was -1.7% (95% CI = -2.6 to -0.7) among blacks, in striking contrast to +3.3% (95% CI = 2.5-4.0) among whites. HPV-related rates rose rapidly among the white men born since the mid-1940s, tripling among those aged 25-44 and recently surpassing the black male rate. Relative survival rates rose over the study period due to improvements among HPV-related cases. CONCLUSIONS: The OCPC decreases found among all the race/sex groups reflect reductions in smoking prevalence and alcohol consumption. Rising HPV-related cancers among white men may reflect changes in sexual practices since the mid-1960s.