Trends and disparities in oropharyngeal cancer mortality in the United States: A retrospective analysis of the CDC WONDER database, 1999-2020.

Abstract

e22555 Background: Oropharyngeal cancers are linked to tobacco, alcohol use, and HPV infection. The 5-year survival rate for oropharyngeal cancer patients in the U.S. is estimated at 52%, according to SEER data. This study analyzes mortality trends for oropharyngeal carcinoma in the U.S. from 1999 to 2020, examining trends across different demographic and geographic groups. Methods: Data from the CDC WONDER database (1999–2020) were used to identify deaths from oropharyngeal neoplasms (ICD-10 code C10). Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent changes (APCs) were computed for different demographic and geographic subgroups using Joinpoint regression (Version 5.1.0, National Cancer Institute). Results: Over the past two decades, there were 21,842 deaths from malignant oropharyngeal cancer. The age-adjusted mortality rate (AAMR) increased from 0.239 in 1999 to 0.394 in 2020, with an annual increase of 1.113% from 1999 to 2013, followed by a more pronounced rise of 4.520% from 2013 to 2020. For females, the AAMR increased modestly (APC: 1.132%), while for males, it rose slightly from 1999 to 2009 (APC: 0.317%), then increased sharply from 2009 to 2020 (APC: 3.998%). AAPC analysis revealed a significant difference between males and females (−1.100, p = 0.009), with males exhibiting a higher increase. Regionally, the South had the highest AAMR (0.322), followed by the Midwest (0.284), Northeast (0.277), and West (0.262). Urban areas had a higher overall AAMR (0.304) compared to rural areas (0.279). Rural areas showed a consistent AAMR increase (APC: 2.485%), while urban areas initially decreased from 1999 to 2006 (APC: −1.474%) before increasing from 2006 to 2020 (APC: 2.967%). The crude death rate was highest in those aged 85+ (1.688). AAMR trends for Black individuals remained higher but showed a decreasing trend (APC: 0.496%), whereas White individuals experienced a modest increase from 1999 to 2008 (APC: 0.908%) and a rapid rise thereafter (APC: 4.070%). The average APC difference between these groups was −3.200 (p < 0.0001), indicating a higher overall mortality trend among Black individuals. Conclusions: The increasing age-adjusted mortality rate for oropharyngeal cancer, especially among males and in urban areas, points to a rising public health concern that demands targeted prevention and early detection. Disparities between Black and White individuals underscore the need for tailored interventions to address these inequalities. Regional differences suggest that implementing region-specific public health policies could help mitigate the rising burden of this disease.