Incidence, mortality and survival of rarer head and neck cancers in New South Wales (#758)
Survival from head and neck cancers is influenced by age at diagnosis, sex, stage at diagnosis, histological features and Human Papillomavirus (HPV) infection status. The incidence of HPV-associated squamous cell carcinomas in males is reported to be increasing globally, and higher nasopharyngeal cancers incidences have been reported in Asian countries.
The NSW Central Cancer Registry was used to calculate age-standardised incidence and mortality rates and unadjusted Kaplan-Meier survival curves for the rarer head and neck cancers - nasopharyngeal, hypopharyngeal, nose and sinuses, salivary gland and oral cavity/other pharynx - between 1990 and 2008.
Incidence per 100,000 for all cancer sites was stable or declined, (mean 1.08 males, 0.41 females), and mortality decreased (mean 0.68) over time. Five-year survival from salivary gland cancer was significantly higher in females than males (81% versus 74%), reflecting less advanced disease at diagnosis (37% localised in females versus 52% in males). No survival differences by sex were observed for the remaining sites studied, but 5-year survival did vary significantly by cancer site. The incidence of nasopharyngeal cancers of all histologies was higher in Asian-born than Australian-born people (SIR 10.02 males and 10.34 females). Squamous cell carcinomas were the most common histology, and in males the incidence of this histology at HPV-associated sites increased over time.
The higher incidence of nasopharyngeal cancer in Asian-born people indicates a probable emerging public health burden for Asian NSW residents. Increasing HPV-associated cancers of the head and neck in males gives further impetus to the vaccination of boys against HPV.