European journal of cancer (Oxford, England : 1990) · 2025
Socioeconomic and environmental disparities in laryngeal cancer incidence and mortality trends based on 57,600 cases.
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Wierzbicka Małgorzata, Świątek Dorota, Barnaś Piotr, Zając Bernard, Pietruszewska Wioletta, Markowski Jarosław
Аннотация
INTRODUCTION: Laryngeal cancer (LC) remains a major public health concern, associated with considerable morbidity and high mortality. Although incidence has historically declined, mortality reduction has been limited, suggesting underlying disparities in disease management. Thus, long-term trends in LC incidence and mortality, stratified by age, sex, regional affluence, and environmental pollution are of importance.
METHODS: Population-based cohort study included 57,600 patients with LC in Poland from 1999 to 2022. Data were analyzed by sex, age group, regional socioeconomic status (Wealth Indicator), and exposure to industrial pollution (Highly Industrialized Region vs. rest of country). Trend comparisons were assessed using slope analysis, while multiple linear regression was applied to model associations between incidence rate (IR) and mortality rates (MR) and key explanatory variables.
RESULTS: Substantial decreases in IR and MR were observed among younger male cohorts (40-59 years), older age groups (60 +) experienced stagnation or increase in mortality. Among women, incidence reductions were less consistent and not mirrored by proportional mortality decreases, especially in the 60-69 and 80 + cohorts. Regions with high environmental pollution showed significantly elevated IR and MR, independently of socioeconomic status. Multivariate models confirmed environmental exposure as a strong predictor of outcomes in the 60-79 age range. Wealth had a moderate impact, affecting mortality more than incidence, particularly in intermediate and low-income regions.
CONCLUSION: This study reveals a shifting burden of laryngeal cancer toward older environmentally exposed populations. It underscores the need for targeted prevention strategies, environmental health policies, and age-specific cancer care improvements.
METHODS: Population-based cohort study included 57,600 patients with LC in Poland from 1999 to 2022. Data were analyzed by sex, age group, regional socioeconomic status (Wealth Indicator), and exposure to industrial pollution (Highly Industrialized Region vs. rest of country). Trend comparisons were assessed using slope analysis, while multiple linear regression was applied to model associations between incidence rate (IR) and mortality rates (MR) and key explanatory variables.
RESULTS: Substantial decreases in IR and MR were observed among younger male cohorts (40-59 years), older age groups (60 +) experienced stagnation or increase in mortality. Among women, incidence reductions were less consistent and not mirrored by proportional mortality decreases, especially in the 60-69 and 80 + cohorts. Regions with high environmental pollution showed significantly elevated IR and MR, independently of socioeconomic status. Multivariate models confirmed environmental exposure as a strong predictor of outcomes in the 60-79 age range. Wealth had a moderate impact, affecting mortality more than incidence, particularly in intermediate and low-income regions.
CONCLUSION: This study reveals a shifting burden of laryngeal cancer toward older environmentally exposed populations. It underscores the need for targeted prevention strategies, environmental health policies, and age-specific cancer care improvements.