[Rising incidence of invasive (T4) head-neck carcinoma at the Utrecht University Medical Center, 1980-1998]

To determine whether there is an increase in the incidence of diagnosed head and neck tumours at an advanced stage (T4).

Secondary data-analysis.

Data of patients registered in 1980-1998 at the Utrecht University Medical Centre, the Netherlands, were analysed for the relative prevalence of T4 tumours in the oral cavity, pharynx and larynx on the basis of sex, age and tobacco and alcohol usage. The results were compared with figures from the Dutch national cancer registry (1989-1997).

Data were collected for 2993 patents (2256 men and 737 women; average age 63 years (SD 12)). Of these 35 had a carcinoma situated on the lips, 1091 in the oral cavity, 1321 in the larynx and 546 in the pharynx. There was an increase in T4 tumours of 12.2% (43/353) of all tumours in 1980-1984 to 27.2% (252/1033) in 1995-1998. Linear regression analysis estimated an increase of 0.9% every year. Selected referral to the Utrecht University Medical Centre was unlikely because the increased incidence of T4 tumours could be recognised in the national cancer registry. There was no change in the sex distribution over the study period. The increase in the 40 to 50-year-old age group was greater than that of the patients aged 80 years and over. T4 tumours were more prevalent than T1 tumours in patients who had smoked 20 or more cigarettes per day or drank more than 4 units of alcohol per day.

The percentage of cancer patients presenting with an advanced stage (T4) of head-neck tumours increased during the study period.