Site-Specific Trends in Tumor Distribution, Treatment Patterns, and Survival in Head and Neck Cancer: A SEER Database Analysis.
- 1Department of MedicineKansas City UniversityJoplinMOUnited States.
- 2Department of MedicineUniversity of UtahSalt Lake CityUTUnited States.
- 3Department of OtolaryngologyFreeman Health SystemJoplinMOUnited States.
Abstract
Introduction
Head and neck cancer (HNC) management has evolved significantly with the introduction of organ-preservation protocols and changing disease etiology.Objective
To analyze site-specific trends in tumor distribution, staging, treatment modality, and survival outcomes using the Surveillance, Epidemiology, and End Results (SEER) program.Methods
A retrospective analysis of 288,132 malignant HNC cases from the SEER program (2000-2021) was performed. Survival analyses were restricted to cases diagnosed between 2000 and 2015 to allow for adequate follow-up. The anatomical sites included the salivary gland, larynx, the oral cavity, the lip, the tongue, the nasopharynx, the oropharynx, and the hypopharynx. Trends in tumor proportion, clinical stage, and treatment modality were assessed using linear regression. Five-year survival trends were analyzed using multivariate logistic regression.Results
The proportion of tongue-cancer diagnoses increased by 12.2% ( p < 0.001), while that of laryngeal cancer decreased by 10.0% ( p < 0.001). Treatment patterns shifted significantly, with the rates of surgery combined with radiation (-11.0%; p < 0.001) and radiation alone (-7.6%; p < 0.001) declining, while that of chemoradiation increased (+16.9%; p < 0.001). The 5-year survival rates improved for hypopharynx (8.5%; p < 0.001), tongue (8.5%; p < 0.001), and oropharynx (8.0%; p < 0.01) cancers.Conclusion
The management of HNC has shifted toward multimodal therapies involving chemotherapy, coinciding with improved survival in pharyngeal and oral subsites. The rising proportion of tongue and oropharyngeal cases may reflect changes in underlying etiologic factors, including human papillomavirus (HPV)-associated disease, although HPV-specific effects cannot be directly assessed in the SEER program.
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BibTeX
@article{stewart2026sitespecific,
title = {{Site-Specific Trends in Tumor Distribution, Treatment Patterns, and Survival in Head and Neck Cancer: A SEER Database Analysis.}},
author = {Christopher Stewart and J B Eyring and Abbigail Niewchas and Joseph Hanny and Grant Sanders and Alex Otto and Randall Hansen and Kent McIntire},
journal = {International archives of otorhinolaryngology},
year = {2026},
month = jul,
doi = {10.1055/a-2884-1665},
url = {https://europepmc.org/article/MED/42921390},
note = {CC BY},
}
RIS
TY - JOUR
TI - Site-Specific Trends in Tumor Distribution, Treatment Patterns, and Survival in Head and Neck Cancer: A SEER Database Analysis.
AU - Christopher Stewart
AU - J B Eyring
AU - Abbigail Niewchas
AU - Joseph Hanny
AU - Grant Sanders
AU - Alex Otto
AU - Randall Hansen
AU - Kent McIntire
PY - 2026
DA - 2026/07/01
JO - International archives of otorhinolaryngology
DO - 10.1055/a-2884-1665
UR - https://europepmc.org/article/MED/42921390
AB - Introduction Head and neck cancer (HNC) management has evolved significantly with the introduction of organ-preservation protocols and changing disease etiology.Objective To analyze site-specific trends in tumor distribution, staging, treatment modality, and survival outcomes using the Surveillance, Epidemiology, and End Results (SEER) program.Methods A retrospective analysis of 288,132 malignant HNC cases from the SEER program (2000-2021) was performed. Survival analyses were restricted to cases diagnosed between 2000 and 2015 to allow for adequate follow-up. The anatomical sites included the salivary gland, larynx, the oral cavity, the lip, the tongue, the nasopharynx, the oropharynx, and the hypopharynx. Trends in tumor proportion, clinical stage, and treatment modality were assessed using linear regression. Five-year survival trends were analyzed using multivariate logistic regression.Results The proportion of tongue-cancer diagnoses increased by 12.2% ( p < 0.001), while that of laryngeal cancer decreased by 10.0% ( p < 0.001). Treatment patterns shifted significantly, with the rates of surgery combined with radiation (-11.0%; p < 0.001) and radiation alone (-7.6%; p < 0.001) declining, while that of chemoradiation increased (+16.9%; p < 0.001). The 5-year survival rates improved for hypopharynx (8.5%; p < 0.001), tongue (8.5%; p < 0.001), and oropharynx (8.0%; p < 0.01) cancers.Conclusion The management of HNC has shifted toward multimodal therapies involving chemotherapy, coinciding with improved survival in pharyngeal and oral subsites. The rising proportion of tongue and oropharyngeal cases may reflect changes in underlying etiologic factors, including human papillomavirus (HPV)-associated disease, although HPV-specific effects cannot be directly assessed in the SEER program.
SN - 1809-9777
SN - 1809-4864
ER -