{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:58:02Z","timestamp":1793145482539,"version":"4.5.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The emergence of human papillomavirus (HPV)\u2013positive oropharyngeal cancer and evolving tobacco use patterns have changed the landscape of head and neck cancer epidemiology internationally. We investigated updated trends in oropharyngeal cancer incidence worldwide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed cancer incidence data between 1993 and 2012 from 42 countries using the Cancer Incidence in Five Continents database volumes V through XI. Trends in oropharyngeal cancer incidence were compared with oral cavity cancers and lung squamous cell carcinomas using log-linear regression and age period\u2013cohort modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 156\u200a567 oropharyngeal cancer, 146\u200a693 oral cavity cancer, and 621\u200a947 lung squamous cell carcinoma patients were included. Oropharyngeal cancer incidence increased (P &amp;lt; .05) in 19 and 23 countries in men and women, respectively. In countries with increasing male oropharyngeal cancer incidence, all but 1 had statistically significant decreases in lung squamous cell carcinoma incidence, and all but 2 had decreasing or nonsignificant net drifts for oral cavity cancer. Increased oropharyngeal cancer incidence was observed both in middle-aged (40-59\u2009years) and older (\u226560\u2009years) male cohorts, with strong nonlinear birth cohort effects. In 20 countries where oropharyngeal cancer incidence increased for women and age period\u2013cohort analysis was possible, 13 had negative or nonsignificant lung squamous cell carcinoma net drifts, including 4 countries with higher oropharyngeal cancer net drifts vs both lung squamous cell carcinoma and oral cavity cancer (P &amp;lt; .05 for all comparisons).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increasing oropharyngeal cancer incidence is seen among an expanding array of countries worldwide. In men, increased oropharyngeal cancer is extending to older age groups, likely driven by human papillomavirus\u2013related birth cohort effects. In women, more diverse patterns were observed, suggesting a complex interplay of risks factors varying by country, including several countries where female oropharyngeal cancer increases may be driven by HPV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djad169","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T15:06:34Z","timestamp":1692630394000},"page":"1544-1554","source":"Crossref","is-referenced-by-count":126,"title":["Global epidemiologic patterns of oropharyngeal cancer incidence trends"],"prefix":"10.1093","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7484-3631","authenticated-orcid":false,"given":"Zachary S","family":"Zumsteg","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Cedars-Sinai Medical Center , Los Angeles, CA, USA"},{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7968-7313","authenticated-orcid":false,"given":"Michael","family":"Luu","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA, USA"},{"name":"Department of Biostatistics and Bioinformatics, Cedars-Sinai Medical Center , Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute , Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia K","family":"Elrod","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute , Bethesda, MD, USA"},{"name":"Department of Statistics and Data Science, Carnegie Mellon University , Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freddie","family":"Bray","sequence":"additional","affiliation":[{"name":"Cancer Surveillance Branch, International Agency for Research on Cancer , Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Vaccarella","sequence":"additional","affiliation":[{"name":"Cancer Surveillance Branch, International Agency for Research on Cancer , Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Gay","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Arizona , Tucson, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana J","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The Queen\u2019s Medical Center , Honolulu, HI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle M","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stanford University , Stanford, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil K","family":"Chaturvedi","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute , Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc T","family":"Goodman","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA, USA"},{"name":"Division of Cancer Prevention and Control, Cedars-Sinai Medical Center , Los Angeles, CA, 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