Head and Neck Cancer Incidence, Mortality, and Disability-Adjusted Life Years From 1990 to 2021-A Systematic Analysis...

This study evaluates the global burden of head and neck cancers, analyzing incidence, mortality, and DALYs from 1990 to 2021, across age groups and regions with varying SDI levels.

Data from the Global Burden of Disease (GBD) database (1990-2021) was utilized to examine incidence, mortality, and DALYs for head and neck cancers. Regional disease trends were analyzed using age-standardized rates (ASR), estimated annual percentage change (EAPC), Joinpoint regression, and the Age-Period-Cohort model. A global map depicted disease burden across 204 countries and territories, 21 GBD regions, and 5 SDI regions.

In 2021, there were 421,577 new lip and oral cavity cancer cases and 208,379 deaths, with DALYs totaling 5,874,070 years. EAPC results indicated rising incidence for lip and oral cavity cancers (EAPC: 0.4% [95% CI: 0.33-0.46]) and other pharyngeal cancers (EAPC: 0.68% [95% CI: 0.6-0.75]). The AAPC model showed an overall increase in incidence for lip and oral cavity cancers (AAPC: 0.442 [0.374-0.511]) and other pharyngeal cancers (AAPC: 0.716 [0.607-0.826]). While mortality rates remained stable or declined. Lip and oral cavity cancer incidence rose most in the middle SDI region, followed by low-middle and low SDI regions, while other pharyngeal cancers saw the highest increase in high, low-middle, and low SDI regions. The AAPC model indicated a declining incidence for lip and oral cavity cancers in all regions except the high SDI region (AAPC: -0.012 [-0.17-0.147]), where other pharyngeal cancers had the highest increase (AAPC: 1.034 [0.741-1.329]). Mortality for lip and oral cavity cancers rose in low-middle SDI regions, while other pharyngeal cancers showed increased mortality in low-middle and low SDI regions. South Asia reported the highest incidence, mortality, and DALYs for lip, oral cavity, and oropharyngeal cancers in 2021. Age-cohort analysis showed that incidence rose until age 55, stabilizing or declining afterward, while the burden of lip and oral cavity cancers increased after 55, with mortality highest over 80.

Head and neck cancer burden is concentrated in low- and middle-income countries, highlighting the need for prevention, early screening, risk factor control, and improved data monitoring in low-income regions.