Head and neck cancer mortality by gender, region and ethnicity: a population-based study in Brazil

Abstract

Background Brazil exhibits the highest mortality rates for oral cavity (OCC), oropharyngeal (OPC), and laryngeal (LC) cancers in South-America. This study aims to analyze mortality trends in head and neck cancers (HNC) across the Brazilian population over 44-year period. Methods A time-series ecological study was conducted using OCC, OPC, LC mortality data. Age-period-cohort (APC) effects and the average annual percent change (AAPC) were estimated for each cancer subsite by gender, regions, ethnicity. Findings From 1980 to 2023, 303,882 HNC deaths were recorded among adults ≥40 years. LC predominated (45.4%), followed by OCC (30.5%), OPC (24.1%). Mortality rates were higher in men, LC showing the highest. After 2000, mortality declines for LC (RR: 0.98 [0.98–1.00 CI 95%]) in men, while women increasing mortality for OPC (RR: 1.12 [1.04–1.21]), OCC (RR: 1.08 [1.02–1.15]). Men born after-1955 showed reduced RR for all subsites, women exhibited for LC. The Northeast region showed an increasing trend across all age groups and cancer subsites. OPC presented an increase in mortality in all regions, in contrast to LC and OCC, which declined in the South and Southeast. White men had a decreasing trend for LC (AAPC −1.62 [−1.99 to −1.26]), OCC (AAPC −1.01 [−1.31 to −0.71]), OPC (AAPC −0.60 [−0.98 to −0.24]), whereas Brown showed an increasing for both genders in all subsites. Interpretation Gender, ethnicity, and geographic location are associated with HNC mortality in Brazil. White men and developed regions showed the most substantial improvements in mortality, while brown, women, and people in the North/Northeast exhibited concerning increases. OPC, although with the lowest rates, shows a growing mortality trend nationwide.