Trends and Drivers of Head and Neck Cancers in Older Adults Over 30 Years: A Population-Based Modelling Study

Head and neck cancers (HNCs) are a significant source of morbidity and contribute to severe functional impairments in older adults globally. Although largely preventable, inadequate mapping of their long-term epidemiological trends and determinants hinders the development of targeted prevention and rehabilitation strategies.

This study analyzed the global incidence and mortality of major HNCs, including nasopharyngeal cancer (NPC), lip and oral cavity cancer (LOCC), other pharyngeal cancer (OPC), and laryngeal cancer (LC) in older adults (60-89 years) from 1992 to 2021. Their temporal and future trends were assessed using Joinpoint regression BAPC models, respectively.

Globally, 464,744 new cases and 303,207 deaths were reported among older adults in 2021. The long-term trends from 1992 to 2021 showed a slight increase in the age-standardized incidence rate (ASIR) and a significant decrease in the age-standardized mortality rate (ASMR). The global ASIR and ASMR for LOCC and OPC increased from 1992 to 2021. However, those for NPC and LC decreased. LOCC and LC were the most prevalent HNCs among older adults globally, followed by OPC and NPC. However, the burden of the four cancers varied across regions. The numbers of cases and deaths from the four HNCs are projected to continue increasing.

The global burden of head and neck cancers in older adults is increasing due to population growth and aging. This trend, particularly the notable rise in OPC, poses a significant challenge for countries with high and low-middle sociodemographic index scores, especially those in America and Europe. Tobacco and alcohol use remain the dominant modifiable risk factors. Addressing these factors is critical to reducing severe swallowing and communication impairments and mitigating the disproportionate burden borne by older adults.