Acta otorrinolaringologica espanola · 2026
Progress and challenges in laryngeal cancer mortality in Spain, 1999-2023.
СтатьяНазвание и аннотация: Перевод в очереди
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Cayuela Lucia, Flox-Benítez Gema, Rodríguez Victoria Achaval, Librero Julián, Cayuela Aurelio
Аннотация
BACKGROUND AND OBJECTIVE: Laryngeal cancer remains a significant public health concern, with pronounced sex- and age-related disparities in mortality. In Spain, recent national analyses are scarce. This study provides a comprehensive assessment of laryngeal cancer mortality trends from 1999 to 2023 and disentangles the contributions of age, period, and cohort effects.
METHODS: We conducted a population-based time-series analysis of laryngeal cancer mortality in Spain over a 25-year period (1999-2023). Age-standardised mortality rates (ASMRs) were calculated, and Joinpoint Regression identified temporal trends. Age-Period-Cohort (A-P-C) modelling (for ages 35-84) decomposes changes into effects attributable to age, period (reflecting clinical management), and birth cohort (reflecting generational risk factor exposure).
RESULTS: A total of 36,598 deaths were recorded, 94% among men. Male ASMRs fell sharply from 12.10 to 4.76 per 100,000, with an annual percentage change (APC) of -4.0%. Female ASMRs remained largely stable. APC modelling for men showed a strong negative net drift (-6.27%), driven by a pronounced negative cohort effect, with rate ratios declining from the 1919-1984 birth cohort. In women, APC analysis revealed an age-dependent reversal: mortality declined in younger women but increased significantly in those aged 55 and over (e.g., APC +4.13% at ages 60-64).
CONCLUSION: Male laryngeal cancer mortality in Spain has declined markedly, primarily due to decreasing smoking-related cohort risks. The rising mortality in older women reflects the delayed impact of past smoking uptake. Continued, gender-sensitive tobacco control strategies are essential.
METHODS: We conducted a population-based time-series analysis of laryngeal cancer mortality in Spain over a 25-year period (1999-2023). Age-standardised mortality rates (ASMRs) were calculated, and Joinpoint Regression identified temporal trends. Age-Period-Cohort (A-P-C) modelling (for ages 35-84) decomposes changes into effects attributable to age, period (reflecting clinical management), and birth cohort (reflecting generational risk factor exposure).
RESULTS: A total of 36,598 deaths were recorded, 94% among men. Male ASMRs fell sharply from 12.10 to 4.76 per 100,000, with an annual percentage change (APC) of -4.0%. Female ASMRs remained largely stable. APC modelling for men showed a strong negative net drift (-6.27%), driven by a pronounced negative cohort effect, with rate ratios declining from the 1919-1984 birth cohort. In women, APC analysis revealed an age-dependent reversal: mortality declined in younger women but increased significantly in those aged 55 and over (e.g., APC +4.13% at ages 60-64).
CONCLUSION: Male laryngeal cancer mortality in Spain has declined markedly, primarily due to decreasing smoking-related cohort risks. The rising mortality in older women reflects the delayed impact of past smoking uptake. Continued, gender-sensitive tobacco control strategies are essential.