Regional differences in incidence and mortality trends in cancers of the larynx, thyroid, oral cavity and pharynx in England and Scotland: 1975-2002


Context: There have been significant changes in the epidemiology of head and neck cancers (HNC) in the last three decades worldwide. Documenting these trends helps to facilitate cancer prevention measures and aids resource allocation. Objective: To analyse incidence and mortality trends in Head and Neck Cancers (HNC) in the UK and compare regional differences between England and Scotland. Design: Retrospective quantitative analysis of time trends of HNC cases in the UK recorded in the International Agency for Research into Cancer (IARC) CI5 database and WHO mortality database. Setting: Cancer databases with extraction of UK HNC incidence and mortality time trends. Patients: All patients with cancers of the larynx, thyroid, oral cavity and pharynx in the UK (1975-2002) recorded in the IARC and WHO databases. Main Outcome Measures: HNC incidence and mortality trends in the UK. Results: There has been an increase in incidence of oral and pharyngeal cancer in the UK especially among males with higher rates in Scotland. However mortality has increased in Scotland and reduced in England. Thyroid cancer incidence has increased in the UK especially among females with higher rates in Scotland. Mortality has reduced in both regions. Laryngeal cancer among males has increased in incidence particularly in Scotland with a decline in incidence in England. Mortality has reduced significantly in England among males but increased in Scotland. Conclusions: In the UK, Scotland has higher incidence rates of HNC compared with England. Mortality has reduced in England from all the HNC sub-sites but has increased in Scotland for laryngeal, oral & pharynxgeal cancers. Although socioeconomic deprivation and its relation to higher alcohol and tobacco consumption have been highlighted as drivers, further studies are required.

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Olaleye, O. , Siddiq, S. , Ekrikpo, U. and Kazi, R. (2013) Regional differences in incidence and mortality trends in cancers of the larynx, thyroid, oral cavity and pharynx in England and Scotland: 1975-2002. Open Journal of Epidemiology, 3, 70-78. doi: 10.4236/ojepi.2013.32011.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Wartofsky, L. (2010) Increasing world incidence of thyroid cancer: Increased detection or higher radiation exposure? Hormones, 9, 103-108.
[2] Olaleye, O., Ekrikpo, U., Moorthy, R., Lyne, O., Wiseberg, J., Black, M. and Mitchell, D. (2011) Increasing incidence of differentiated thyroid cancer in South East England: 1987-2006. European Archives of Oto-Rhino-Laryngology, 268, 899-906. doi:10.1007/s00405-010-1416-7
[3] Reynolds, R.M., et al. (2005) Changing trends in incidence and mortality of thyroid cancer in Scotland. Clinical Endocrinology, 62, 156-162. doi:10.1111/j.1365-2265.2004.02187.x
[4] Wier, J., Brewster, D.H. and Strachan, M.W.J. (2003) The epidemiology of thyroid cancer in Scotland, 1960-1999. Endocrine Abstracts, 5, 261.
[5] Davies, L. and Welch, H.G. (2006) Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA, 295, 2164-2167. doi:10.1001/jama.295.18.2164
[6] Morris, L. and Myssiorek, D. (2010) Improved detection does not fully explain the rising incidence of well-differentiated thyroid cancer: A population-based analysis. The American Journal of Surgery, 200, 454-461. doi:10.1016/j.amjsurg.2009.11.008
[7] Cramer, J.D., et al. (2010) Analysis of the rising incidence of thyroid cancer using the surveillance epidemicology and end results national cancer data registry. Surgery, 148, 1147-1153. doi:10.1016/j.surg.2010.10.016
[8] dos Santos Silva, I. and Swedlow, A.J. (1993) Thyroid cancer epidemiology in England and Wales: Time trends and geographical distribution. British Journal of Cancer, 67, 330-340. doi:10.1038/bjc.1993.61
[9] Cotterill, S.J., Pearce, M.S. and Parker, L. (2001) Thyroid cancer in children and young adults in the north of England. Is increasing incidence related to the Chernobyl accident? European Journal of Cancer, 37, 1020-1026. doi:10.1016/S0959-8049(00)00449-4
[10] Kitahara, C.M., Platz, E.A., Freeman, L.E., Hsing, A.W., Linet, M.S., Park, Y., Schairer, C., Schatzkin, A., Shikany, J.M. and Berrington de González, A. (2011) Obesity and thyroid cancer risk among US men and women: A pooled analysis of five prospective studies. Cancer Epidemiology, Biomarkers & Prevention, 20, 464-472.
[11] Grant, I., Fischbacher, C. and Whyte, B. (2007) Obesity in Scotland: An epidemiology briefing. ScotPHO, ISD, Edinburgh.
[12] Office of National Statistics (2006) Cancer statistics registrations. Registrations of cancer diagnosed in 2004, England. Series MB1 No. 35.
[13] Goddard, E. (Ed.) (2006) Smoking and drinking amongst adults, 2005. Office of National Statistics.
[14] Conway, D.I. (2010) Everything in Moderation? Evidence-Based Dentistry, 11, 89-90. doi:10.1038/sj.ebd.6400744
[15] Warnakulasuriya, S. (2009) Global epidemiology of oral and oropharyngeal cancer. Oral Oncology, 45, 309-316. doi:10.1016/j.oraloncology.2008.06.002
[16] Warnakulasuriya, S., Mak, V. and Moller, H. (2003) Oral cancer survival in young people in South East England. Oral Oncology, 43, 982-986.
[17] Shiboski, C.H., Schmidt, B.L. and Jordan, R.C. (2005) Tongue and tonsil carcinoma: Increasing trends in the US population ages 20 - 44 years. Cancer, 103, 1843-1849.
[18] Swerdlow, A.J., dos Santos Silva, I., Reid, A., Qiao, Z., Brewster, D.H. and Arrundale, J. (1998) Trends in cancer incidence and mortality in Scotland: Description and possible explanations. British Journal of Cancer, 77, 1-54. doi:10.1038/bjc.1998.424
[19] MacFarlane, G.J., Evstifeeva, T.V., Scully, C. and Boyle, P. (1993) The descriptive epidemiology of pharyngeal cancer in Scotland. European Journal of Epidemiology, 9, 587-590. doi:10.1007/BF00211431
[20] Allen, N.E., Beral, V., Casabonne, D., Kan, S.W., Reeves, G.K., Brown, A. and Green, J. on Behalf of Million Women Study Collaborators (2009) Moderate alcohol intake and cancer incidence in women. Journal of the National Cancer Institute, 101, 296-305.
[21] Hindle, I., Downer, M.C., Moles, D.R. and Speight, P.M. (2000) Is alcohol responsible for more intraoral cavity cancer? Oral Oncology, 36, 328-333. doi:10.1016/S1368-8375(00)00020-8
[22] Klaussman, J.P., Weissenborn, S.J., Wieland, U., et al. (2003) Human papillomavirus-positive tonsillar carcinomas: A different tumour entity? Medical Microbiology and Immunology (Berlin), 192, 129-132. doi:10.1007/s00430-002-0126-1
[23] Hobbs, C.G., Sterne, J.A., Bailey, M., Heyderman, R.S., Birchall, M.A. and Thomas, S.J. (2006) Human papillomavirus and head and neck cancer: A systematic review and meta-analysis. Clinical Otolaryngology, 31, 259-266.
[24] Riechelmann, H. (2010) Human papilloma virus in head and neck cancer. Laryngo-Rhino-Otologie, 89, 43-48.
[25] Gillespie, M.B., Smith, J., Gibbs, K., McRackan, T., Rubinchik, S., Day, T.A. and Sutkowski, N. (2008) Human papilloma virus and head and neck cancer: A growing concern. Journal—South Carolina Medical Association, 104, 247-251.
[26] Badaracco, G. and Venuti, A. (2007) Human papilloma virus therapeutic vaccines in head and neck tumors. Expert Review of Anticancer Therapy, 7, 753-766.
[27] Lopez-Lizarraga, E., Sanchez-Corona, J., Montoya-Fuentes, H., Bravo-Cuellar, A., Campollo-Rivas, O., Lopez-Demerutis, E., Morgan-Villela, G., Arcaute-Velazquez, F., Monreal-Martinez, J.A. and Troyo, R. (2000) Human papilloma virus in tonsillar and nasopharyngeal carcinoma: Isolation of HPV subtype 31. Ear, Nose & Throat Journal, 79, 942-944.
[28] Luginbuhl, A., Sanders, M. and Spiro, J.D. (2009) Prevalence, morphology, and prognosis of human papilloma virus in tonsillar cancer. Annals of Otology, Rhinology & Laryngology, 118, 742-749.
[29] Pintos, J., Black, M.J., Sadeghi, N., Ghadirian, P., Zeitouni, A.G., Viscidi, R.P., Herrero, R., Coutlee, F. and Franco, E.L. (2008) Human papillomavirus infection and oral cancer: A case-control study in Montreal, Canada. Oral Oncology, 44, 242-250.
[30] Tran, N., Rose, B.R. and O’Brien, C.J. (2007) Role of human papillomavirus in the etiology of head and neck cancer. Head & Neck, 29, 64-70.
[31] Begum, S., Cao, D., Gillison, M., Zahurak, M. and Westra, W.H. (2005) Tissue distribution of human papillomavirus 16 DNA integration in patients with tonsillar carcinoma. Clinical Cancer Research, 11, 5694-5699.
[32] Gillison, M.L. and Lowy, D.R. (2004) A causal role for human papillomavirus in head and neck cancer. Lancet, 363, 1488-1489. doi:10.1016/S0140-6736(04)16194-1
[33] Ryerson, A.B., Peters, E.S., Coughlin, S.S., Chen, V.W., Gillison, M.L., Reichman, M.E., Wu, X., Chaturvedi, A.K. and Kawaoka, K. (2008) Burden of potentially human papilloma-virus associated cancers of the oropharynx and oral cavity in the US, 1998-2003. Cancer, 113, 2901-2909.
[34] Mehanna, H., et al. (2010) Oropharyngeal carcinoma related to human papillomavirus. Institute of Head and Neck Studies and Education, University Hospital, Coventry.
[35] Wiest, T., Schwarz, E., Enders, C., et al. (2002) Involvement of intact HPV 16 E6/E7 gene expression in head and neck cancers with unaltered p53 status and perturbed pRb cell cycle control. Oncogene, 21, 1510-1517. doi:10.1038/sj.onc.1205214
[36] Van Houten, V.M., Snijders, P.J., van den Brekel, M.W., et al. (2001) Biological evidence that human papilloma-viruses are etiologically involved in a subgroup of head and neck squamous cell carcinomas. International Journal of Cancer, 93, 232-235. doi:10.1002/ijc.1313
[37] Koskinen, W.J., Chen, R.W., Leivo, I., et al. (2003) Prevalence and physical status of human papillomavirus in squamous cell carcinomas of the head and neck. International Journal of Cancer, 107, 401-406. doi:10.1002/ijc.11381
[38] Mehanna, H., Jones, T.M., Gregoire, V. and Ang, K.K. (2010) Oropharyngeal carcinoma related to human paillomavirus. British Medical Journal, 340, c1439. doi:10.1136/bmj.c1439
[39] Junor, E.J., Kerr, G.R. and Brewster, D.H. (2010) Oropharyngeal cancer: Fastest increasing cancer in Scotland, especially in men. British Medical Journal, 340, c2512. doi:10.1136/bmj.c2512
[40] La Vecchia, C., Lucchini, F., Negri, E. and Levi, F. (2004) Trends in oral cancer mortality in Europe. Oral Oncology, 40, 433-439. doi:10.1016/j.oraloncology.2003.09.013
[41] Gillison, M.L., D’Souza, G., Wesra, W., et al. (2008) Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. Journal of the National Cancer Institute, 100, 1-14. doi:10.1093/jnci/djn025
[42] Heck, J.E., Bethiller, J., Vaccarella, S., et al. (2010) Sexual behaviours and the risk of head and neck cancers: A pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. International Journal of Epidemiology, 39, 166-181. doi:10.1093/ije/dyp350
[43] Gillison, M.L., Broutian, T., Pickard, R.K.L., et al. (2012) Prevalence of oral HPV infection in the United States, 2009-2010. JAMA, Published Online.
[44] Copas, A.J., Wellings, K., Erens, B., et al. (2002) The accuracy of reported sensitive sexual behaviour in Britain: Exploring the extent of change 1990-2000. Sexually Transmitted Infections, 78, 26-30. doi:10.1136/sti.78.1.26
[45] MacKenzie, K., Savage, S.A. and Birchall, M.A. (2009) Processes and outcomes of head and neck cancer patients from geographically disparate regions of the UK. A comparison of Scottish and English cohorts. European Journal of Surgical Oncology, 35, 1113-1118. doi:10.1016/j.ejso.2009.04.001
[46] McMahon, J.D., Robertson, G.A., Liew, C., McManners, J., Mackenzie, F.R., Hislop, W.S., Morley, S.E., Devine, J., Carton, A.T., Harvey, S., Hunter, K. and Robertson, A.G. (2011) Oral and oropharyngeal cancer in the West of Scotland-long-term outcome data of a prospective audit 1999-2001. British Journal of Oral and Maxillofacial Surgery, 49, 92-98. doi:10.1016/j.bjoms.2009.12.013
[47] Macfarlane, G.J., Sharp, L., Porter, S. and Franceschi, S. (1996) Trends in survival from cancers of the oral cavity and pharynx in Scotland: A clue as to why the disease is becoming more common? British Journal of Cancer, 73, 805-808. doi:10.1038/bjc.1996.141

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