Trends in the incidence of head and neck cancer: A nationwide population-based study

Objective: This study aimed to demonstrate the temporal trend in incidence of head and neck cancer (HNC) in Taiwan. Materials and methods: Patients with a HNC were retrieved from the Taiwan's Health Insurance Database. We identified 16,894 patients aged ≥20 years who had received a first-time diagnosis of cancer of the oral cavity, oropharynx, larynx, hypopharynx, nasopharynx, sinonasal, salivary gland or thyroid gland between 2010 and 2018. We calculated the annual incidence rate per 100,000 population, overall, and classified by gender and cancer type. We also used the annual percent change (APC) to characterize trends in head and neck cancer rates over time. Results: The incidence rate showed a gradual decline during this period from 2010 to 2018 with an APC of −2.81% (p < 0.001). Within gender groups, the decline was not statistically significant among females (APC = −1.69, 95% CI = −3.58 ∼ 0.23, p = 0.080). Within cancer types, strikingly high magnitude and statistically significant declines were observed in respect of cancer of the nasopharynx (APC = −7.89%, 95% CI = −9.43%∼−6.31%, p < 0.001), sinonasal cancer (APC = −10.08%, 95% CI = −16.66%∼−2.99%, p = 0.012) and oropharyneal cancer (APC = −9.47%, 95% CI = −15.15%∼−3.42%, p = 0.013) over the study period. In contrast, there was a statistically significant increase in incidence on thyroid cancer over the study period with an APC of 4.75% (95% CI = −2.81%∼6.75%, p < 0.001). Conclusions: HNCs in Taiwan are showing a decreasing trend, led by the upper respiratory and oropharyngeal cancers. However, there was a concurrent increasing trend of the incidence on thyroid cancer. These trends may be attributable to changing lifestyles and behavioral choices in Taiwan.