Mortality trends and disparities affecting pharyngeal cancer in the US: A 21-year retrospective analysis of CDC WONDER database.

Abstract

e18144 Background: Pharyngeal cancer, or throat cancer, includes nasopharyngeal, oropharyngeal, and hypopharyngeal cancers, with the most common histologic subtype being squamous cell carcinoma. According to the SEER program, the five-year survival rate for cancer of the oral cavity and pharynx is 69%. This study aims to evaluate mortality trends associated with pharyngeal cancer across the U.S population and examine variations in these trends based on demographic and social factors. Methods: A population-based observational analysis was conducted, capturing data from all 50 U.S. states and the District of Columbia regarding mortality rates of pharyngeal cancer. The analysis used death certificates from the CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database, spanning more than two decades from 1999 to 2020. Data were stratified by age, gender, race, urbanization, and census region. Age-Adjusted Mortality Rates (AAMR) per 100,000 people were assessed with corresponding 95% confidence intervals (CIs) and results were reported as Annual Percentage Change (APC). Results: A total of 94,408 deaths from pharyngeal cancer were reported between 1999 and 2020 with an overall average AAMR of 1.235. The highest mortality rate was observed in the South region, with an AAMR of 1.699 (95% CI: 1.617–1.781) in 1999, declining to 1.345 (95% CI: 1.288–1.403) in 2020 (APC; –1.09). Males experienced a significant decline in mortality rates, with an APC of –1.67 until 2009, followed by a gradual decline of –0.30 from 2009 to 2020. African Americans had the highest mortality rates, with an AAMR of 2.719 (95% CI: 2.516–2.922) in 1999, which declined to 1.434 (95% CI: 1.323–1.544) by 2020. In contrast, the White population showed a rapid decline in mortality during the first decade (APC of –1.28) but slowed down significantly during the second decade (APC; –0.30). Non-metropolitan areas had higher mortality rates compared to metropolitan areas. Finally, the 65+ age group had the highest mortality rates among all age groups, with an AAMR of 6.69 in 1999, declining to 5.74 in 2020. Conclusions: Mortality rates from pharyngeal cancer have gradually declined over the past two decades, with notable decreases in the South and among males, although disparities persist across regions, race, and geographical location. Targeted strategies are needed to address the higher mortality rates in African Americans, non-metropolitan areas, and older populations. Demographic characteristics of deaths due to pharyngeal cancer in the United States from 1999-2020. Variable Subgroup Deaths AAMR (95% CI) per 100,000 Overall Overall 94,408 1.23 (1.22-24) Gender Male 70,037 2.07 (2.00-2.15) Female 24,371 0.58 (0.55-0.62) Race Black 14,812 1.95 (1.80-2.10) White 74,719 1.16 (1.12-1.20) Age (years) 25-44 2,623 0.15 (0.12-0.18) 45-64 36,579 2.05 (1.95-2.16) 65+ 54,884 5.99 (5.75-6.23)