Rates of oropharyngeal cancer continue to rise steeply amongst Australian men: continued emphasis on HPV vaccination, tobacco and alcohol control

Objective: To analyse trends in incidence of oropharyngeal cancers (OPC) across Australia from 1982 to 2017 with implications for prevention. Methods Data were obtained from the Australian Cancer Database (ACD) compiled at the Australian Institute of Health and Welfare (AIHW). Incidence rates of OPC were expressed per 100,000 population, age-standardized in accordance with WHO standard population. Joinpoint analyses are presented. Results A striking increase of age-standardised incidence rate (ASIR) of OPC by over 1.5 times from 1.86/100,000 in 1982 to 3.23/100,000 in 2017 was observed in men: the most significant rise was between 2007 and 2017 with an annual percentage change (APC) of + 5.24% (p < 0.001). Slow but gradual growth of ASIR from 0.38/100,000 in 1982 to 0.71/100,000 in 2017 was observed among women with a statistically significant APC of + 1.02% (p < 0.001). Statistically significant bimodal increasing trends of APC were also observed in total ASIR of OPC. Highest number of incident cases were found in patients aged 55 to 69 years old, accounting for 50.8% on average of all ages during each 7-year time period. Most common subsites affected were base of tongue (BOT) and “oropharynx” from 1982 to 2017. Conclusion OPC is rising rapidly across Australia, particularly in men. Whilst the national proportion of cases driven by HPV is not known, it is evident that vaccination is yet to have an impact. A substantial proportion of cases are, presumably, still driven by traditional alcohol and tobacco habits, mandating continued efforts at control of these risk factors.