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. 2021 Jan;43(1):108-115.
doi: 10.1002/hed.26465. Epub 2020 Sep 12.

National trends in oropharyngeal cancer incidence and survival within the Veterans Affairs Health Care System

Jose P Zevallos  1   2 , Jennifer R Kramer  3   4 , Vlad C Sandulache  5   6   7 , Sean T Massa  1   2 , Christine M Hartman  3 , Angela L Mazul  1   2 , Benjamin M Wahle  1 , Sophie P Gerndt  1 , Erich M Sturgis  5   6 , Elizabeth Y Chiao  3   4
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Free PMC article

National trends in oropharyngeal cancer incidence and survival within the Veterans Affairs Health Care System

Jose P Zevallos et al. Head Neck. 2021 Jan.
Free PMC article

Abstract

Background: Oropharyngeal squamous cell carcinoma (OPSCC) epidemiology has not been examined previously in the nationwide Veterans Affairs (VA) population.

Methods: Joinpoint regression analysis was applied to OPSCC cases identified from VA administrative data from 2000 to 2012.

Results: We identified 12 125 OPSCC cases (incidence: 12.2 of 100 000 persons). OPSCC incidence declined between 2000 and 2006 (annual percent change [APC] = -4.27, P < .05), then increased between 2006 and 2012 (APC = 7.02, P < .05). Significant incidence increases occurred among white (APC = 7.19, P < .05) and African American (APC = 4.87, P < .05) Veterans and across all age cohorts. The percentage of never-smokers increased from 8% in 2000 to 15.7% in 2012 (P < .001), and 2-year overall survival improved from 31.2% (95% confidence interval (CI) [30-33.4]) to 55.7% (95% CI [54.4-57.1]).

Conclusions: OPSCC incidence is increasing across all racial and age cohorts in the VA population. Smoking rates remain high among Veterans with OPSCC and gains in survival lag those reported in the general population.

Keywords: Veterans Affairs; human papilloma virus; joinpoint; oropharyngeal cancer; survival.

Figures

FIGURE 1
FIGURE 1
Joinpoint regression analysis, oropharyngeal cancer incidence in the Veterans Health Administration (VHA) population, 2000-2012. An asterisk following the annual percentage change (APC) value indicates statistical significance (P < .05) [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Joinpoint regression analysis, oropharyngeal cancer incidence in the Veterans Health Administration (VHA) population by age group, 2000-2012. A, Age <50; B, age 50 to 69; C, age >70. An asterisk following the annual percentage change (APC) value indicates statistical significance (P < .05) [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Joinpoint regression analysis, oropharyngeal cancer incidence in the Veterans Health Administration (VHA) population by race, 2000-2012. A, Non-Hispanic white; B, African Americans. An asterisk following the annual percentage change (APC) value indicates statistical significance (P < .05) [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 4
FIGURE 4
Oropharyngeal cancer survival in the Veterans Health Administration (VHA) population. A, Overall survival per group defined by joinpoint regression analysis: 2000-2006 and 2007-2012; B, overall survival per year of diagnosis: 2000-2012 [Color figure can be viewed at wileyonlinelibrary.com]
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