Prognostically relevant demographic factors: a nationwide cancer registry study with inclusion of 212.920 head and neck cancer patients

Introduction Demographic factors play an essential epidemiological and prognostic role in various malignancies. A recent, Germany-wide analysis of cancer registry data of head and neck tumors (HNC) is not yet available.

Methods A retrospective analysis of data from the Center for Cancer Registry Data and the Federal Statistical Office between 2002 and 2017 was performed. 212’920 patients with HNC (HNCP) were included. Incidence, tumor stage, sex distribution, age-, residence-, and diagnosis-time-specific survival were examined.

Results The mean age of all HNCP increased more rapidly than that of the German population during the observation period (slope coefficient: 0.29 vs. 0.20; p<0.0001). The proportion of older (> 70 years) HNCP increased from 20.6% in 2002 to 34.4% in 2017. The median survival of all HNCP was 57 months, compared with only 35 months for older HNCP with no improvement trend over time. In West Germany, median survival was 60 months and in East Germany, 47 months (p<0.0001). This disparity was associated with a disproportionately high proportion of men in East Germany (men/women: 4.4 vs. 3.1; 0 < 0.0001) with a lower median age (61 vs. 63 years; p<0.0001). However, location-specific (east vs. west) differences in incidence and tumor stage were not evident. In addition, multivariate analysis confirmed place of residence as a prognostic factor.

Conclusion The relative incidence of HNC is decreasing in the younger population, possibly due to preventive measures and lifestyle changes. In contrast, the proportion of older patients is increasing. More than 30 years after reunification, a survival disadvantage for patients in East Germany becomes apparent. Reasons for this discrepancy could be of socioeconomic nature.

Publication History

Article published online:
12 May 2023