Age-specific incidence and treatment patterns of head and neck cancer in the Netherlands-A cohort study

Objectives: To explore the incidence and treatment pattern of head and neck cancer in different age groups. Design: Cohort study. Setting: Netherlands Cancer Registry. Participants: All new primary head and neck cancer cases diagnosed between 2010 and 2014 were included and categorised into different age groups. Main outcome measures: Tumour site, stage, treatment modality, location of diagnosis and treatment. Results: The study population was composed of 11 558 tumours. Oral cancer was the most common primary site (31%), followed by laryngeal (25%) and oropharyngeal cancer (22%). Ninety-six per cent of the entire study population was diagnosed and/or treated in a certified head and neck oncology centre which was lower in the 80+ population (92%). Multimodality treatment was less frequently applied with increasing age (eg oral cavity: 17% in 80+ vs 34% in 60 +/-; P <.001). The percentage of patients not receiving tumour-directed treatment increased with age (eg oropharyngeal cancer: 25% in 80+ vs 6% in 80 +/-; P <.001). Conclusions: This study confirms that less multimodal and tumour-directed treatment is applied with the increasing age of head and neck cancer patients.