Divergent Trends in Head and Neck Cancer Burden in China (1990-2021)

To systematically quantify China's head and neck cancer burden (1990-2021) and inform prevention strategies through analysis of nasopharyngeal carcinoma (NPC), esophageal cancer, and oral cancer trends.

Data were sourced from the Global Burden of Disease Study 2021. Age-standardized incidence rate (ASIR), mortality, and disability-adjusted life year (DALY) rates were analyzed. Temporal trends were evaluated using estimated annual percentage changes (EAPC).

During 1990-2021, China observed an overall burden reduction for NPC and esophageal cancer, whereas oral cancer demonstrated rising ASIR (EAPC = 1.75) despite slight declines in mortality and DALY rates, likely reflecting improved survival from earlier detection and advances in treatment. Esophageal cancer showed significant decreases in both ASIR (EAPC = -1.88) and DALY rate (EAPC = -2.67). Gender disparities revealed consistently higher male burdens across all three cancers, though females experienced steeper declines; oral cancer showed divergent trends with substantial male ASIR growth (EAPC = 2.39) versus female improvements. Regarding age distribution, the incidence of NPC and esophageal carcinoma declined among children, young adults, and middle-aged individuals but escalated in elderly men. The incidence of oral cancer increased notably with age.

Declining NPC and esophageal cancer burdens contrasted with increasing oral cancer ASIR in China (1990-2021). While males carried disproportionately higher burdens, females exhibited more rapid improvements. The sharply escalating cancer incidence among elderly males underscores critical needs for targeted interventions in high-risk demographics alongside sustained prevention efforts for younger populations.