A Snapshot of Head and Neck Cancer
Incidence and Mortality
Cancers of the head and neck, which include cancers of the oral cavity, larynx, pharynx, salivary glands, and nose/nasal passages, account for approximately three percent of all malignancies in the United States. Overall incidence for cancers of the oral cavity and pharynx began decreasing 30 years ago and stabilized in 2003. The overall incidence for cancers of the larynx has been decreasing each year since 1988. Overall mortality rates for head and neck cancers have declined since 2001. Notably, the incidence of head and neck cancers in African Americans has declined over the past two decades and is now lower than that in whites. The mortality rate also has decreased among African Americans but is still higher than that in whites.
Tobacco and alcohol use are the most important risk factors for most head and neck cancers. In addition, infection with certain types of human papillomavirus (HPV), particularly HPV type 16 (HPV16) and HPV type 18 (HPV18), causes more than half of all cases of oropharyngeal cancer, a type of head and neck cancer. There are no standard or routine screening tests for head and neck cancers. Standard treatments for head and neck cancers, which depend on the tumor location, the tumor stage, and the patient’s age and overall health, include radiation therapy, surgery, chemotherapy, targeted therapy, or a combination of treatments.
Assuming that incidence and survival rates follow recent trends, it is estimated that $3.6 billion1 will be spent on head and neck cancer care in the United States in 2014.
NCI’s Investment in Head and Neck Cancer Research
To learn more about the research NCI conducts and supports in head and neck cancer, visit the NCI Funded Research Portfolio (NFRP). The NFRP includes information about research grants, contract awards, and intramural research projects funded by NCI. When exploring this information, it should be noted that approximately half of the NCI budget supports basic research that may not be specific to one type of cancer. By its nature, basic research cuts across many disease areas, contributing to our knowledge of the underlying biology of cancer and enabling the research community to make advances against many cancer types. For these reasons, the funding levels reported in NFRP may not definitively report all research relevant to a given category.
Other NCI programs and activities relevant to head and neck cancer include:
- Through the Cancer Genome Atlas (TCGA) program, researchers are systematically identifying the major genomic changes involved in more than 20 cancers, including cancers of the head and neck, using state-of-the-art genomic technologies. Additionally, the TCGA Pan-Cancer analysis project is comparing mutations across tumor types to identify genomic similarities; such similarities could raise the prospect that similar treatments could be useful for multiple cancer types. [PubMed Abstract]
- The Epidemiology and Genomics Research Program supports interdisciplinary and translational cancer research including the International Head and Neck Cancer Epidemiology Consortium, which facilitates collaborative research on the epidemiology of head and neck cancer, and the development and use of resources and technologies to advance cancer epidemiology and its translation into clinical and public health practice.
- The Early Detection Research Network (EDRN) is identifying and testing new biomarkers to improve cancer detection and risk assessment. One EDRN project aims to improve and validate a noninvasive serum-based assay using a panel of cancer-specific biomarkers for early cancer detection in patients with head and neck squamous cell carcinoma (HNSCC).
- The Head and Neck Steering Committee is identifying and promoting the “Best Science” in head and neck clinical research by addressing the design and prioritization of phase III trials and large phase II trials in head and neck cancer. One recently activated phase II trial is investigating whether the addition of surgery to treatment with radiation therapy and cisplatin chemotherapy prolongs progression-free survival in patients with oropharyngeal cancer.
- The Biomarker, Imaging and Quality of Life Studies Funding Program (BIQSFP) is currently supporting biomarker, imaging, and quality of life studies, with or without cost-effectiveness analysis, that are associated with randomized cancer clinical trials. One BIQSFP study, a randomized phase II/III trial, is comparing three combinations of chemotherapy and radiation therapy given after surgery to see which of two experimental combinations prolongs disease-free survival and overall survival in patients with advanced HNSCC compared with a control combination.
- Four Specialized Programs of Research Excellence (SPOREs) in head and neck cancer support translational research on cancers of the upper aerodigestive tract and on thyroid cancer. SPORE researchers are developing biomarkers that can be used for early detection, monitoring, surveillance, and prognosis of head and neck cancer and are developing novel strategies for treatment and prevention.
Selected Advances in Head and Neck Cancer Research
- Antibodies against HPV16 were found in blood samples from patients who developed oropharyngeal cancer more than 10 years after the sample was obtained, suggesting that the antibodies may identify those at increased risk of this cancer. Published June 2013. [PubMed Abstract]
- In a randomized trial, a vaccine that prevents cervical infection with HPV types 16 and 18 was also highly effective in preventing oral infection with HPV types 16 and 18, suggesting that HPV vaccination may protect against oral HPV infections and possibly prevent HPV-associated oropharyngeal cancers. Published July 2013. [PubMed Abstract]
- An integrated proteomic-genomic analysis of tumors from HNSCC patients identified a subset of tumors with mutations that correlate with higher levels of the activated tumor promoting protein STAT3, suggesting that inhibition of the STAT3 pathway may be a potential therapeutic strategy for treating HNSCC patients with these mutations. Published January 2014. [PubMed Abstract]
- A noninvasive imaging tool that detects chemical changes in cellular metabolism, which can be disrupted by some cancer treatments, detected early responses to targeted drugs and chemotherapy in head and neck cancer cell lines. Early detection of drug efficacy could reduce toxicities, costs, and time associated with ineffective therapy. Published March 2014. [PubMed Abstract]
Additional Resources for Head and Neck Cancer
- What You Need To Know About™ Oral Cancer
Describes possible risks, symptoms, diagnosis, and treatment for someone recently diagnosed with oral cancer.
- What You Need To Know About™ Cancer of the Larynx
Describes possible risks, symptoms, diagnosis, and treatment for someone recently diagnosed with laryngeal cancer.
- Head and Neck Cancer Home Page
NCI's gateway for information about head and neck cancers.
- Head and Neck Cancers
A fact sheet about the risk factors, symptoms, diagnosis, treatment, follow-up, and rehabilitation for cancers of the head and neck.
- Laryngeal Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of laryngeal cancer.
- Lip and Oral Cavity Treatment (PDQ®)
Expert-reviewed information summary about the treatment of lip and oral cavity cancer.
- Oropharyngeal Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of oropharyngeal cancer.
- Hypopharyngeal Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of hypopharyngeal cancer.
- Nasopharyngeal Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of nasopharyngeal cancer.
- Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of paranasal sinus and nasal cavity cancer.
- Salivary Gland Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of salivary gland cancer.
- Clinical Trials for Laryngeal Cancer
- Clinical Trials for Lip and Oral Cavity Cancer
- Clinical Trials for Oropharyngeal Cancer
- Clinical Trials for Hypopharyngeal Cancer
- Clinical Trials for Nasopharyngeal Cancer
- Clinical Trials for Paranasal Sinus and Nasal Cavity Cancer
- Clinical Trials for Salivary Gland Cancer
- 1 Cancer Prevalence and Cost of Care Projections, in 2010 dollars..
- 2 FY 2009 head and neck cancer funding includes thyroid cancer funding.