Incidence and Survival of Oral Tongue Cancers among Adult Women in the US; 1973-2010 Open Access
Joseph, Lindsay Jannine (2014)
Abstract
Background: The incidence of oral tongue cancer (OTC) in the United States is reported to be increasing in women. To better understand this phenomenon, we sought to examine the time trends and racial disparities in incidence and survival in this population.
Methods: We identified 6,199 women diagnosed with OTC who were reported to the Surveillance, Epidemiology and End Results (SEER) Program from 1973 to 2010. Cases were categorized by age, race, year of diagnosis and residential setting. The incidence rates were compared across various demographic categories by calculating rate ratios (RRs) with the corresponding 95% confidence intervals (CIs). We also examined temporal variations in incidence of OTC across racial groups using joinpoint analyses to evaluate changes since 1973. Racial differences in survival were examined using Cox regression models after controlling for age, stage, and type of treatment received.
Results: OTC incidence in white females demonstrated a statistically significant increase with 0.53 annual percentage change (APC) between 1973 and 2010. For African-American (AA) females, on the other hand, the incidence has decreased by -2.79 APC since 1973. Overall incidence was higher among white women (1.30 cases per 100,000/year) compared to AA women (0.67 cases per 100,000/year). Survival of AA women was significantly lower than that among white OTC patients. The racial disparity in survival was less pronounced after controlling for age, stage, and treatment. Other significant predictors of poor survival were advanced age and stage. Better survival was associated with tumor directed surgery, and radical removal and examination of neck lymph nodes, but not radiation therapy.
Conclusions: The increase in OTC incidence among women over the last four decades is limited to whites. Identifying the demographic characteristics of this group may lead to a better understanding of the causes behind this increase. The racial disparity in survival is pronounced, but appears to be explained in large part by differences in stage at diagnosis, and receipt of care.
Table of Contents
INTRODUCTION 1
METHODS 3
Study subjects 3
Statistical analysis 4
RESULTS 6
Incidence Rates 6
Survival Analysis 7
DISCUSSION 9
CONCLUSION 12
REFERENCES 13
TABLES 16
FIGURES 20
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