Head and neck cancer cases between 1980 and 2019 were obtained from the national Taiwan Cancer Registration (TCR) database (https://twcr.tw/ ). The Taiwan Cancer Registration (TCR) database has collected newly diagnosed cancer cases from hospitals with 50 or more beds in Taiwan since 1979 [9 (link), 10 (link)]. In addition, the completeness of the TCR, the percentage of cases with death certificates, and the percentage of morphological verification in 2016 were respectively 98.4, 0.9, and 93%, while the completeness was measured by all registered cancer cases divided by all potential cancer cases from profiles of death certificate, NHI catastrophic illnesses, and four major cancer screening programs [9 (link)]. All cases in this analysis were classified based on the International Classification of Diseases for Oncology, third edition (ICD-O-03) [11 ]. Head and neck cancer cases were categorized into oral cancer (C00, C02, C03, C04, C050, C058, C059, and C06, excluding C024), oropharyngeal cancer (C01, C024, C051, C052, C09, C10, C142, and C148), hypopharyngeal cancer (C12, C13, and C140), and laryngeal cancer (C32).
Based on the 2000 World Health Organization standard population, the age-adjusted incidence rate in men from 1980 to 2019 was only analyzed due to the low incidence in women in Taiwan. For the analysis of long-term trends, the age-specific incidence rate from 1980 to 2019 was calculated for specific age groups, time periods, and birth cohorts. The age-specific incidence rate was classified into eighteen 5-year age groups (0–4, 5–9, 10–14, 15–19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84, and 85+) and eight 5-year time periods (1980–1984, 1985–1989, 1990–1994, 1995–1999, 2000–2004, 2005–2009, 2010–2014, and 2015–2019). In addition, the birth cohort was divided into eleven birth groups (1930–1934, 1935–1939, 1940–1944, 1945–1949, 1950–1954, 1955–1959, 1960–1964, 1965–1969, 1970–1974, 1975–1979, and 1980–1984) and twelve 5-year age groups (30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84, and 85+). Moreover, to describe the linear change in the age-adjusted incidence rate from 1980 to 2019, a join point regression model was utilized to detect the change point and calculate the average annual percent change (AAPC) and annual percent change (APC) [10 (link)]. In addition, the 95% confidence intervals of the average annual percent change (AAPC) and annual percent change (APC) were analyzed. 95% confidence interval indicated 95% would fall between the upper limit and the lower limit, while 95% confidence interval including 0 showed statistically nonsignificant. The research protocol was approved by the Institutional Review Board of Fu-Jen Catholic University (No. C104014).
Based on the 2000 World Health Organization standard population, the age-adjusted incidence rate in men from 1980 to 2019 was only analyzed due to the low incidence in women in Taiwan. For the analysis of long-term trends, the age-specific incidence rate from 1980 to 2019 was calculated for specific age groups, time periods, and birth cohorts. The age-specific incidence rate was classified into eighteen 5-year age groups (0–4, 5–9, 10–14, 15–19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84, and 85+) and eight 5-year time periods (1980–1984, 1985–1989, 1990–1994, 1995–1999, 2000–2004, 2005–2009, 2010–2014, and 2015–2019). In addition, the birth cohort was divided into eleven birth groups (1930–1934, 1935–1939, 1940–1944, 1945–1949, 1950–1954, 1955–1959, 1960–1964, 1965–1969, 1970–1974, 1975–1979, and 1980–1984) and twelve 5-year age groups (30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84, and 85+). Moreover, to describe the linear change in the age-adjusted incidence rate from 1980 to 2019, a join point regression model was utilized to detect the change point and calculate the average annual percent change (AAPC) and annual percent change (APC) [10 (link)]. In addition, the 95% confidence intervals of the average annual percent change (AAPC) and annual percent change (APC) were analyzed. 95% confidence interval indicated 95% would fall between the upper limit and the lower limit, while 95% confidence interval including 0 showed statistically nonsignificant. The research protocol was approved by the Institutional Review Board of Fu-Jen Catholic University (No. C104014).
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