The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing among older patients residing in the United States, likely due to the increase in human papillomavirus (HPV)-associated malignancies, a study published in JAMA Oncology has shown.1

Previous research has demonstrated that the incidence of HPV-related OPSCC is on the rise, predominantly among middle-age adults. Because HPV DNA has been found in the majority of OPSCC diagnosed in patients 65 years or older in tissue studies, researchers sought to examine the trends in OPSCC incidence in the United States according to age.

For the study, investigators analyzed data from 40,264 patients with OPSCC, certain tobacco-related cancers, and HPV-related anal cancer included in the Surveillance, Epidemiology, and End Results (SEER) database All OPSCC diagnoses were made between 2000 and 2012, and 33.1% of cases involved patients age 65 years or older.

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Results showed significant increases in the incidence of OPSCC during the study period for both young patients age 45 to 64 years (P <.001) and older patients age 65 years or older (P <.001). Researchers found that these increases were driven mostly by base-of-tongue and tonsil cancers in men.

In contrast, investigators observed decreasing incidences of tobacco-associated head and neck cancer among older patients (P <.001), but the incidence of HPV-related anal cancer significantly increased over time (P <.001).

In terms of survival, both overall and cancer-specific survival improved over time for both younger and older patients with OPSCC; however, cause-specific survival continued to be worse for older patients compared with those age 45 to 64 years (P <.001).

“Given the unique challenges related to treating elderly patients with OPSCC, their limited enrollment in clinical trials, and the aging US population, clinical studies investigating improved therapeutic strategies for elderly patients with HPV-positive OPSCC should be performed,” the authors conclude.


1. Zumsteg ZS, Cook-Wiens G, Yoshida E, et al. Incidence of oropharyngeal cancer among elderly patients in the United States. JAMA Oncol. 2016 Jul 14. doi: 10.1001/jamaoncol.2016.1804. [Epub ahead of print]