(0664) Incident Predictors of Oropharyngeal Cancers: An Analysis of the National Childhood Cancer Registry Database

Introduction: This project’s goal was to analyze and compare population data for oropharyngeal cancer subtypes to determine at risk populations for further investigation of novel exposures and potential causes associated with the disparity between incident rates of oropharynx cancers.

Methods: The NCCR SEER database identified patients diagnosed with oral cavity and pharyngeal cancer from 1975-2020. Demographic, pathologic subtype, and survival trends were analyzed by year over year trendline analysis followed with a thorough literature review of known and theorized risk factors for oropharyngeal cancer development in discussion.

Results: Calculated annual percent change rates in overall reported incident rates of pharyngeal cancers rose 1.1% between the years 2000-2016 for the first time since the database began reporting rates in 1975. When analyzed along demographic trends the analysis by race found a statistical drop of 1.5% in incidence among Black Americans while incidence among Indian Americans concerningly rose 3.8%. Within the subtypes the most shocking finding was a cumulative incidence increase of 29.9% for gingival cancer amongst Indian Americans between the years 2000 and 2019.

Conclusions: Of the known oropharyngeal cancer risk factors, tobacco use is one of the highest correlated however a national decline in cigarette and tobacco use has occurred during the same period of increasing incidence. Previous studies have shown that HPV infection, once considered a risk factor for all oropharyngeal cancers, is more specifically associated with lingual cancer development and the 2% increase in lingual cancer follows the national 2.75% annual percent increase in HPV diagnoses during the same time frame. What remains to be addressed is the disproportionate 29.9% increase of gingival cancer amongst Indian Americans despite a national decline in cigarette use. Studies have found that Indian Americans as a demographic have not mirrored the declining rate of cigarette use and have actually increased their reported frequency. Further work must be done to effectively reach this at risk and vulnerable community.