3023 - Geographic and Demographic Trends in Head and Neck Cancer Mortality in the United States (1999-2020)
Presenter(s)
P. Ashar1, K. Tamirisa2, S. Garg3, and P. Karanam4; 1Duke University, Durham, NC, 2Washington University in St. Louis, St. Louis, MO, 3University of Georgia, Athens, GA, 4Smilow Cancer Hospital at Saint Francis Center, Trinity Health of New England, Hartford, CT
Purpose/Objective(s): Head and neck cancer (HNC) remains a significant cause of cancer-related mortality in the United States. While treatment advancements have improved survival, disparities in mortality persist across demographic and geographic subgroups. This study aims to analyze national trends in age-adjusted mortality rates (AAMRs) among HNC patients from 1999 to 2020, with a focus on key demographic and geographic factors, including sex, race, urban-rural classification, and region. By identifying patterns in HNC mortality, this study seeks to highlight areas where targeted public health interventions may help reduce disparities.
Materials/Methods: Mortality data from the CDC WONDER database were analyzed for individuals over the age of 35 between 1999 and 2020, where HNC (ICD-10 codes C00-C06, C09-C10, C11, C12-C13, C14.0-C14.2, C32) was recorded as the underlying cause of death. AAMRs per 100,000 individuals were calculated, and temporal trends were examined using Joinpoint regression. Differences in mortality rates were further assessed by sex, race, urban-rural classification, and geographic region.
Results: Over the study period, a total of 254,041 deaths were attributed to HNC. Between 1999 and 2020, the AAMR for patients with HNC declined from 7.6 (95% CI, 7.4–7.7) to 6.2 (95% CI, 6.1–6.3), with an annual percent change of -1.04% (p<0.001). Across all cases, cumulative AAMRs were higher in males (10.7 [95% CI, 10.7–10.8]) compared to females (3.2 [95% CI, 3.2–3.2]). Racial differences were evident, with African Americans exhibiting the highest AAMR (9.1 [95% CI, 9.0–9.2]), followed by White individuals (6.4 [95% CI, 6.4–6.4]), American Indians (4.6 [95% CI, 4.3–4.8]), and Asians (4.3 [95% CI, 4.2–4.4]). Urban-rural differences were also observed, with noncore rural regions experiencing higher mortality rates (7.5 [95% CI, 7.4–7.6]) compared to large central metropolitan areas (6.6 [95% CI, 6.6–6.7]). Regionally, the South exhibited the greatest disease burden (7.3 [95% CI, 7.3–7.4]), followed by the Midwest (6.6 [95% CI, 6.6–6.7]), Northeast (6.1 [95% CI, 6.1–6.2]), and West (5.8 [95% CI, 5.7–5.8]).
Conclusion: While HNC-related mortality has decreased over time, disparities remain prevalent across sex, race, and geography. Males, African Americans, and rural populations continue to bear a disproportionate burden. Regional variations further underscore the need for localized public health initiatives. Addressing these disparities through enhanced screening, targeted education, and equitable healthcare access may improve outcomes for high-risk populations.