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Global burden of head and neck cancers including thyroid cancer in older adults (≥ 60 years old) and projections to 2050: a systematic and comprehensive analysis of the global burden of disease study 2021

Xianglong Li,Zhong Du,W. Tan,Shuang Wu,Chenxi Wang,Yujie Pan,Fengnian Han,Guoxu Wang,Wanying Xie,Man Zhu,Ling Han,Xi Zhang,Qingyu Zhou

Published 2025 in BMC Geriatrics

ABSTRACT

Head and neck cancers (HNC), including laryngeal cancer (LC), lip and oral cavity cancer (LOC), nasopharyngeal cancer (NPC), thyroid cancer (TC), and various other oropharyngeal cancers (OPC), significantly impact the physical and mental health of older adults. This study seeks to comprehensively assess the burden of HNC among older adults (≥ 60 years old) in various regions and countries worldwide, covering the time frame from 1990 to 2021. Data regarding the incidence, mortality rates, and disability-adjusted life years (DALYs) were gathered from the Global Burden of Disease (GBD) 2021 to assess the impact of female cancers—specifically LC, LOC, NPC, TC and OPC—among older adults worldwide. A trend analysis was performed by employing the joinpoint regression to evaluate temporal changes, and the average annual percentage change (AAPC) was computed to measure these trends. Moreover, the Age-Period-Cohort (APC) model was applied to examine the influences of age, time, and birth cohort on incidence, mortality, and DALYs. Additionally, to predict the impact of HNC over the forthcoming 30 years, the Bayesian Age-Period-Cohort (BAPC) model was utilized. In 2021, the global incidence of HNC was reported as 612,067.03 cases (95% uncertainty interval [UI]: 555,776.85–662,604.36), resulting in an age-standardized incidence rate (ASIR) of 56.27 (95% UI: 51–60.93). The number of recorded deaths was 348,000.2 (95% UI: 313,328.89–378,923.15), leading to an age-standardized death rate (ASDR) of 32.34 (95% UI: 29.06–35.22). The total number DALYs was 7,330,871.21 (95% UI: 6,641,999.58–7,977,099.69), with an age-standardized DALY rate of 669.03 (95% UI: 605.54–728.07). An analysis of age-standardized trends indicates a gradual upward trend in ASIR, with an estimated annual percentage change (EAPC) of 0.15 (95% confidence interval [CI]: 0.07–0.22). In contrast, the ASDR and age-standardized DALYs have shown a decreasing trend, with EAPC of -0.57 (95% CI: [-0.65] - [-0.5]) and − 0.66 (95% CI: [-0.74] - [-0.58]), respectively. Notably, a significant increase in female patients has been observed. The age distribution profile indicates that the highest incidence of HNC occurs in the 60–64 age group for both sexes. Mortality rates peak in the 65–69 age group, also affecting both sexes, while the burden of DALYs is most significant in the 60–64 age group. Among the various subtypes of HNC, cancers of the LOC represent the most substantial disease burden. The global incidence of HNC continues to rise, despite a decline in mortality rates, highlighting significant regional disparities. This discrepancy is particularly evident in South Asia, where a high disease burden is attributed to tobacco use, HPV infections, and limitations in healthcare access. Although targeted interventions have improved outcomes for male populations, regions with low Socio-demographic Index (SDI) are now experiencing an increase in incidence among women. The disease predominantly affects adults aged 60 to 69, emphasizing the necessity for focused screening, especially for older women. Key risk factors include tobacco and alcohol use, elevated Body Mass Index (BMI), and occupational exposures. Current projections suggest that these factors will continue to drive an increase in global HNC cases in the coming years.

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