Abstract 7378: Trends in head and neck cancer: Incidence, mortality and distant metastasis disparities from SEER data

Abstract Introduction: Head and neck cancer (HNC) is the seventh most common cancer globally. Approximately 10% of HNCs present with distant metastases (DM) at diagnosis, with a median survival of less than one year. Lower socioeconomic status (SES) has been associated with advanced stage HNCs. Socioeconomic disparities have been reported in HNC incidence and mortality. However, the role of SES among individuals with HNC who develop DM remains less explored. We analyzed trends in the HNC incidence and mortality rates in the U.S. and identified sociodemographic predictors of DM using data from the Surveillance, Epidemiology, and End Results (SEER) database. Methods: This study used publicly available SEER Data from 2000-2022. Descriptive statistics were calculated for the full incident cohort (N=303, 196: human papilloma virus (HPV) related HNC: 85, 531; non-HPV: 217, 665) and the subset of cases with DM (n=33575). Age-adjusted incidence and mortality rates per 100, 000 population and annual percentage changes (APC) were calculated using SEER*Stat version 8.4.4. Poisson regression was used to identify sociodemographic predictors of DM such as age, sex, race/ethnicity, marital status, income, and metropolitan/non-metropolitan status using SAS version 9.4. The 95% confidence intervals (CIs) and p-values for incidence rate ratios (IRR) were reported. Results: Age-adjusted incidence and mortality rates of HNC were 14.9 and 2.6 per 100, 000 population, respectively. Slight decreases in incidence (APC: -0.2; 95% CI: (-0.4, -0.1); p<0.0001) and mortality (APC: -0.6; 95% CI: (-0.8, -0.4); p<0.0001) were observed. Oropharyngeal cancers (HPV-related) exhibited increased incidence (APC: 3.9; 95% CI: (3.1, 4.7); p<0.0001) and mortality (APC: 3.0; 95% CI: (2.5, 3.5); p<0.0001). Laryngeal cancers had decreased incidence (APC: -2.6; 95% CI: (-2.7, -2.4); p<0.0001) and mortality (APC: -2.1; 95% CI: (-2.2, -2.0); p<0.0001). About 11% of HNC cases had DM, with higher rates for individuals aged 50-64 years (IRR: 1.09; 95% CI: (1.06, 1.13) ; ref: 20-49 years), males (IRR: 1.21; 95% CI: (1.18, 1.24)), non-Hispanic (NH) Asian or Pacific Islanders (IRR: 1.50; 95% CI: (1.44, 1.56)); ref: NH White) and those with an income of $40K-$74, 999 (IRR: 1.61; 95% CI: (1.48-1.75); ref: $75K or more). Advanced age at diagnosis (80+ years: IRR: 0.89; 95% CI: (0.85, 0.93)), being married or partnered (IRR: 0.84; 95% CI: (0.82, 0.86); ref: others) and living in non-metropolitan areas (IRR: 0.89; 95% CI: (0.86, 0.92); ref: metropolitan areas) were associated with lower rates of DM. Conclusions: The incidence and mortality rates of HNCs have declined since 2000 whereas the rates have increased for HPV associated HNC. Our study highlights the need for understanding the causes of more advanced disease in subgroups of the population, and to refine the risk categories such as specific Asian or Pacific Islander populations and geographic classification. Citation Format: Laraib Mazhar, Li Zhang, Jeremy Ireland, Vonn Walter, Li Wang, Jessica M. Yingst, Sophia I. Allen, Jonathan Foulds, Joshua Muscat. Trends in head and neck cancer: Incidence, mortality and distant metastasis disparities from SEER data [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7378.