Pediatric head and neck malignancies: US incidence and trends over 2 decades

Background: Recent reports have noted an increase in the overall incidence of pediatric cancer. Objective: To determine whether this trend is applicable to malignancies of the head and neck in children. Design: Using the National Cancer Institute's Surveillance, Epidemiology, and End Results tumor database, we determined the incidence of all cancers diagnosed from 1973 through 1996 in children younger than 19 years. This was compared with the incidence of head and neck malignancies within the same population. Rates were then determined for eight 3-year periods from 1973-1975 to 1994-1996 and adjusted by use of three 5-year age groups weighted by the 1970 US standard population. Results: A total of 24960 malignancies diagnosed in children younger than 19 years were identified for the study period. From this group, 3050 tumors (12%) were located in the head and neck. The average annual rate of all cancer (number of malignancies per 100000 person-years) in children younger than 15 years rose 25% from 11.22 (95% confidence interval [CI], 10.70-11.74) for 1973-1975 to 14.03 (95% CI, 13.46-14.60) for 1994-1996. Among malignancies of the head and neck, the incidence rate increased 35% from 1.10 (95% CI, 0.94-1.26) to 1.49 (95% CI, 1.30-1.68) during the same period. Conclusion: The incidence of head and neck malignancies among children younger than 15 years in the United States from 1973 through 1996 increased at a greater rate than childhood cancer in general.