Epidemiology of head and neck cancer in the United States.

BACKGROUND Cancer rates of the head and neck are traditionally linked to public health issues. OBJECTIVE To describe the epidemiology of head and neck cancer in the United States. DESIGN AND SETTING National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program. RESULTS A total of 75,000 cases of head and neck cancer were diagnosed in 2001. Incidence is rising in thyroid (up 52%), bone (43%) soft tissues (20%), salivary (20%), tongue (16%), tonsil (12%), and nose (12%). Incidence is falling in lip (down 58%), hypopharynx (35%), cervical esophagus (32%), oropharyngeal mucosa (26%), and larynx (26%). There were 30,000 deaths from head and neck cancer in 2001. Mortality has decreased to some degree at all sites except thyroid where it was stable. CONCLUSION Many head and neck cancers have changing incidence and mortality rates contrary to expected changes given trends in public health issues. Further investigation of risk factors, diagnostic practices, and management strategies is warranted. EBM RATING 2C.