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Pediatric Head and Neck Malignancies in the United States: A 20-Year Population-Based Study
Simo Kraguljac1, Fouad Hajjar2, Richard Wong3
1University of Central Florida College of Medicine, Orlando, Florida, USA.
Insights
Pediatric head and neck cancers are increasing, with higher incidence in females and a bimodal age distribution peaking in very young children and late adolescents. These trends highlight the need for updated treatment strategies.
Area of Science:
- Oncology
- Epidemiology
- Pediatrics
Background:
- Limited recent epidemiologic data on pediatric head and neck (HN) cancers in the US.
- Need for updated trends to inform future treatment strategies.
Purpose of the Study:
- To analyze current epidemiologic trends of pediatric HN cancers in the US.
- To identify changes in incidence rates over time and by age group.
Main Methods:
- Analysis of the Surveillance Epidemiology and End Results (SEER) database from 2000 to 2019.
- Inclusion of patients aged 0-21 years with HN malignancies.
- Examination of incidence rates and demographic variations.
Main Results:
- Pediatric HN tumors represent 16.7% of all pediatric cancers, with a mean age of 13.1 years.
- Overall incidence increased by 28.5% from 2000-2004 to 2015-2019, outpacing overall pediatric cancer growth.
- A bimodal incidence pattern was observed, with peaks in very young children (<1 year) and late adolescents (15-21 years).
Conclusions:
- Pediatric HN tumors show a bimodal age distribution and an increasing incidence trend.
- Female predominance is noted, largely due to thyroid carcinoma.
- Updated data and trend analysis are crucial for advancing treatment protocols for pediatric HN cancers.
Background:
Epidemiologic data for pediatric head and neck (HN) cancers in the United States (US) have not been reported in many years. An update is essential to highlight trends to guide future treatment.
Methods:
We analyzed the Surveillance Epidemiology and End Results database from 2000 to 2019. We included patients aged <1-21 years with a malignancy in the HN region. We also report trends in incidence rates over time.
Results:
HN tumors encompassed 16.7% of all pediatric tumors with a mean age of 13.1 years. Females accounted for 59.0% of tumors. The female predominance is largely due to thyroid carcinoma; if thyroid malignancies are excluded male incidence is higher. The overall incidence (0-19 years) was found to be 3.29 malignancies per 100,000 person-years. The incidence from 2000 to 2004 was 2.84 [95% CI, 2.77, 2.91] while from 2015 to 2019 was 3.65 [3.57, 3.73]. This increase of 28.5% was greater than overall pediatric cancer, which increased by 13.7%. Incidence varies significantly by age group with 4.56 [4.35, 4.78] at age <1, 2.45 [2.37, 2.53] from 1 to 4 years, 1.46 [1.40, 1.51] from 5 to 9 years, 2.27 [2.21, 2.34] from 10 to 14 years, 4.81 [4.71, 4.90] from 15 to 19 years, and 7.35 [7.17, 7.40] from 20 to 21 years. Thus, there is a bimodal rise at the extremes of the pediatric age group.
Conclusions:
Pediatric HN tumors more commonly affect females. These tumors appear in a bimodal distribution; they most commonly present in very young patients and then during late adolescence The incidence has increased since 2000 and faster than overall incidence. Reporting of these data and trends will allow for advancement in treatment.
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