Rising mean age of head and neck squamous cell carcinoma patients in a German tertiary referral center during a 15-year observation period

Introduction The influence of demographic change on the age at diagnosis of patients with head and neck squamous cell carcinoma (HNSCC) in Germany is undetermined. With rising numbers of patients with oropharyngeal carcinoma, the increase of a younger subpopulation of patients with human papilloma viruses is reported contemporaneously. We present an analysis of age trends in newly diagnosed HNSCC in a tertiary reference center.

Methods This is a retrospective cohort study on the age development of patients with initial diagnosis of head and neck cancer who were treated at the Head and Neck Tumor Center of the Comprehensive Cancer Center Ulm between 2004 and 2018. The results were related to demographic data of the same catchment area and statistically evaluated.

Results The study population consisted of 2450 persons with diagnosed HNSCC with a mean age of 62.84 (±11.67) years. We observed a steady increase in annual incidence rates and mean age over the observation period. The age differences were significant from 2014 to 2018. While there was no shift in the incidence rate of patients under 50 years of age, the incidence of HNSCC patients increased most at age 70 and older. The mean age of patients with oropharyngeal and hypopharyngeal carcinomas increased significantly over the period studied. Surprisingly, HPV-positive patients were not significantly younger than HPV-negative patients but tended to be older.

Conclusion Increasing incidence rates, especially in older patients with HNSCC, pose a crucial challenge to the health care system. A nationwide study is needed to assess the dynamics and impact of aging on the incidence of HNSCC.

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