Surveillance of Tonsillar Cancer Incidence Rates in Minority Groups vs Non-Hispanic Whites in Large US Metropolitan...

BACKGROUND: For oropharyngeal (OP) cancers at anatomical sites regarded as related to human papillomavirus (HPV), surveillance using population-based cancer registries has shown that age-standardized incidence rates are higher in US non-Hispanic whites (NHWs) vs minority groups. Surveillance in large racially-ethnically diverse urban areas also should be considered. METHODS: Using the US Cancer Statistics database, age-standardized incidence rates per year were obtained for 2003–2013 for carcinomas of the tonsil, the OP site most strongly associated with HPV. Data were available for NHWs, non-Hispanic blacks (NHBs), and Hispanic whites (HWs) in 20 large metropolitan statistical areas (MSAs), and for Asian-Pacific Islanders in 8 of these MSAs. Trends in annual rates were examined using join-point regression. RESULTS: The overall rate (2003–2013) was higher for NHWs vs each minority group in almost all MSAs. Little or no NHW–NHB difference was found in 3 MSAs, using abbreviated titles: San Francisco, with a relatively high rate for NHBs; San Diego, with high rates for both groups; and Detroit, with a low rate for NHWs and a high rate for NHBs. For individual MSAs with sufficient data for trends in at least 1 minority group, rising rates for NHWs diverged from NBHs and HWs in New York, and from NHBs in Chicago but not from NHBs in Detroit. For HWs, rates increased statistically significantly in the Miami MSA, vs a smaller increase in the Los Angeles MSA and no increase in the New York MSA. CONCLUSIONS: Surveillance of OP carcinoma incidence by MSA appears justified, but should use databases that attempt to collect information on racial– ethnic subgroups (eg, birthplace and/or ancestry for HWs).