Changes in survival in head and neck cancers in the late 20th and early 21st century: a period analysis.

BACKGROUND Therapy for head and neck cancers has evolved over the past decade, but few detailed analyses of recent developments in survival on the population level have been published. METHODS We use period analysis and modeled period analysis to disclose recent trends in survival in patients with head and neck cancer. Data are derived from the Surveillance, Epidemiology, and End Results limited-use database. RESULTS A major, statistically significant improvement in survival was observed, with the overall 5-year relative survival rate going from 54.7% in 1992-1996 to 65.9% in 2002-2006. Subgroup analysis showed improvement in cancers of the oral cavity, tongue, tonsils, and nasopharynx, with the greatest improvements observed in tonsillar carcinoma (+22.2 percentage points) and carcinoma of the tongue (+14.4 percentage points). Further analysis of survival for oral cavity, tonsillar, and tongue carcinoma revealed improvements in survival at each stage and across all age groups except for patients aged ≥ 75 years, with the greatest improvement occurring in locally advanced disease and in patients aged 55-64 years for carcinoma of the tongue and tonsils and those aged 15-44 years for oral cavity cancers. CONCLUSIONS Survival has substantially improved for head and neck cancer patients over the past decade. The greatest improvement was seen in tonsillar and tongue cancers.