Divergent Trends in Head and Neck Cancer Burden in China (1990-2021).
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INTRODUCTION: To systematically quantify China's head and neck cancer burden (1990-2021) and inform prevention strategies through analysis of nasopharyngeal carcinoma (NPC), esophageal cancer, and oral cancer trends. METHODS: Data were sourced from the Global Burden of Disease Study 2021. Age-standardized incidence rate (ASIR), mortality, and disability-adjusted life year (DALY) rates were analyzed. Temporal trends were evaluated using estimated annual percentage changes (EAPC). RESULTS: During 1990-2021, China observed an overall burden reduction for NPC and esophageal cancer, whereas oral cancer demonstrated rising ASIR (EAPC = 1.75) despite slight declines in mortality and DALY rates, likely reflecting improved survival from earlier detection and advances in treatment. Esophageal cancer showed significant decreases in both ASIR (EAPC = -1.88) and DALY rate (EAPC = -2.67). Gender disparities revealed consistently higher male burdens across all three cancers, though females experienced steeper declines; oral cancer showed divergent trends with substantial male ASIR growth (EAPC = 2.39) versus female improvements. Regarding age distribution, the incidence of NPC and esophageal carcinoma declined among children, young adults, and middle-aged individuals but escalated in elderly men. The incidence of oral cancer increased notably with age. CONCLUSION: Declining NPC and esophageal cancer burdens contrasted with increasing oral cancer ASIR in China (1990-2021). While males carried disproportionately higher burdens, females exhibited more rapid improvements. The sharply escalating cancer incidence among elderly males underscores critical needs for targeted interventions in high-risk demographics alongside sustained prevention efforts for younger populations.