Abstract C93: Head and neck cancer trends in Trinidad and Tobago
Authors: Ragin Camille , Liu Jeffrey , Blackman Elizabeth , Roach Veronica , Devarajan Karthik , Ashing Kimlin Tam , Gathere Samuel , Taioli Emanuela 
Published: May 2015

Background: Head and neck squamous cell carcinoma (HNSCC) include tumors that arise in the oral cavity, pharynx and larynx. A steady decline in HNSCC incidence has been observed world-wide, and is likely attributed to declining prevalence of tobacco and alcohol consumption. Exceptions to this observation have been a steady increase in the incidence of cancers arising in the oropharnyx/tonsil which has been associated in the United States and Europe with an increasing incidence of HPV-positive tumors. Survival from head and neck cancer is poor, ∼50%; however HPV-related oropharyngeal cancer patients are known to have significant longer survival compared to non-oropharyngeal cancer patients. To date there are no data reported for the Caribbean Islands.

Objective: To review head and neck cancer (HNSCC) incidence and outcomes in Trinidad and Tobago (TT) and compare trends to that of the United States.

Methods: National cancer registry data from the Dr. Elizabeth Quamina National Cancer Registry of Trinidad and Tobago was obtained for 742 HNSCC cases diagnosed between 1995-2007. Squamous cell cancers of the oral cavity, pharynx, and larynx were analyzed. Data from the US SEER database were obtained for age adjusted incidence comparison. Kaplan-Meier survival analyses was performed on the two groups.

Results: The majority (323, 43.5%) of TT patients had larynx cancer, were of African ancestry (296, 39.9%), with East Indians representing a significant minority (230, 31.0%). The male:female cancer ratio was 4.5:1. Female patients were more likely to have oral cancer (OR 3.7, CI 2.5-5.4), and less likely larynx cancers (OR 0.3, CI 0.2-0.5). The majority of African ancestry patients were diagnosed with larynx cancer (44%), while the majority of Indians were diagnosed with oral cavity tumors (38.1%). Age-adjusted incidence trends in TT and the US SEER database showed a decrease in larynx cancers until 2001 when a rise in TT larynx cancers was identified. While a rise in oropharynx prevalence was seen in the SEER data from 1995-2006, oropharynx cancer remained on the steady decline in TT. Survival in this series was poor with 16.9% 5y localized disease specific survival (DSS), and 6.3% and 8.7% regional and distant metastasis 5y DSS. No survival advantage was seen in TT oropharynx cases versus non-oropharynx cases.

Conclusions: Most HNSCC in TT are diagnosed in African ancestry males with larynx cancer. Indian patients and females were more likely to have oral cancer. No increase in oropharynx cancers were seen the TT registry in recent years, a clear difference from US SEER data over the same period. HNSCC survival is uniformly poor.

Citation Format: Camille Ragin, Jeffrey Liu, Elizabeth Blackman, Veronica Roach, Karthik Devarajan, Kimlin Tam Ashing, Samuel Gathere, Emanuela Taioli. Head and neck cancer trends in Trinidad and Tobago. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C93. doi:10.1158/1538-7755.DISP13-C93