Epidemiology

The US National Cancer Institute estimates that, in 2024, there will be 58,450 new cases of oropharyngeal cancer and 12,230 deaths due to the disease. This is based on an incidence of 11.5 new cases per 100,000 persons per year between 2017 and 2021, and a death rate of 2.6 deaths per 100,000 persons per year between 2018 and 2022. SEER: cancer stat facts: oral cavity and pharynx cancer Opens in new window

Most patients (70%) present with nodal disease at diagnosis. In human papillomavirus (HPV)-independent oropharyngeal cancer, nodal disease suggests advanced locoregional disease. This is not necessarily true in HPV-associated oropharyngeal cancer, because patients with limited ipsilateral nodal disease in the neck are still considered stage 1.

HPV infection is considered the primary cause of oropharynx cancer, as the number and proportion of HPV-16-positive tumours has increased, and continues to rise in the developed world.[8]​ HPV- associated cancer affects patients with fewer comorbidities and less exposure to tobacco and alcohol. An increase in HPV-associated oropharyngeal cancers has been noted in the US, from 16% in 1984 to >70% in 2000.​[8][9]​​​​ A retrospective analysis of the US Surveillance, Epidemiology, and End Results (SEER) database found that the rate of HPV-associated oropharyngeal cancer increased by 2.5% per year (P <0.0001) from 2002 to 2012. Meanwhile, the overall rate of head and neck cancer decreased by 0.22% per year (P=0.0549) and the rate of laryngeal cancer decreased by 1.9% per year (P <0.0001) during the same time period.[10]​ White, non-Hispanic men have the highest incidence of HPV-associated oropharyngeal cancers.[11][12]

As with other sites of head and neck cancer, HPV-independent oropharyngeal cancers are associated with smoking and alcohol exposure.[13]​​​[14][15]​​​​​​​​​ In developing countries, chewing-tobacco and betel nuts are also associated with oropharyngeal cancers.[16]

Use of this content is subject to our disclaimer