Aims:
With falling smoking rates and a rise in oropharyngeal cancer (OPC), primarily driven by HPV, the changing demographics of this disease have important clinical resource and research implications. We sought to conduct a statewide population-based review of OPC diagnoses, mortality, and treatment in Queensland.
Methods:
The Queensland Oncology Repository (QOR) collates and matches patient-level administrative and clinical data from the Queensland Cancer Register with public and private hospital admissions, pathology, radiology, treatment, and mortality data. Persons newly diagnosed with OPC between 2000-2015 were identified using QOR. This study focused on outcomes for 2011-2015.
Results:
Between 2000 and 2015 the age-standardised incidence of OPC increased by 162% in males (from 4.2 to 11.0 new cases per 100,000 males) and by 41% in females (from 1.4 to 1.9 per 100,000 females). During the same period, the age-standardised incidence of oral cavity cancer, previously the most common head and neck cancer (HNC) diagnosed, decreased in males by 35% (from 7.0 to 4.6 per 100,000 males) and remained relatively stable in females (from 3.9 to 4.0 per 100,000 females).
OPC is now the most common HNC diagnosed in Queensland. During the 2011-2015 study period, 1,285 OPC were identified. The median age at diagnosis for OPC was 59 in males and 60 in females, compared with 63 (both male and female) for all HNCs, reflecting the younger age profile of OPC. Eighty-one percent of OPC patients received radiation therapy, 70% systemic therapy and 33% surgery. One-year relative survival for OPC was high at 87%, compared with 84% for all HNCs.
Conclusions:
This analysis provides statewide confirmation of the changing demographics of HNC. Based on current trends this study highlights the greater need for resource allocation, ongoing research funding for OPC and the promotion of the national vaccination program in males and females.