Progress against laryngeal cancer in The Netherlands between 1989 and 2010

Cancer of the larynx is a frequently occurring head and neck cancer in The Netherlands. The main risk factors are smoking and excessive alcohol consumption. The aim of our study was to evaluate the progress against laryngeal cancer by studying trends in incidence, mortality and survival in The Netherlands. All patients in The Netherlands Cancer Registry diagnosed with invasive primary squamous cell carcinoma of the larynx during the period 1989-2010 were included for analysis. Time trends in incidence, mortality, treatment and survival were described for the total group and stratified by sex and subsite: glottis, supraglottis and subglottis. The most frequently affected subsite for men was the glottis (69%) and for women the supraglottis (55%). Glottic cancer was diagnosed at lower stages than supraglottic cancer. Incidence and mortality rates decreased for males with -2.5 and -2.8% per year, respectively, but remained stable for women, except for an increasing mortality rate in older women (EAPC: +2.5%). Five-year relative survival rates were stable for glottic (85%) and supraglottic (50%) cancer, whereas patients with high-staged cancers more often received radiotherapy. Multivariable analysis showed lower relative excess risks of dying for women, younger patients (What's new? Cancer of the larynx is a common malignancy in The Netherlands and is linked to smoking and abundant alcohol consumption. As this study shows, however, while incidence and mortality rates for laryngeal cancer decreased for Dutch males over the period 1989-2010, in line with changes in smoking habits, rates remained stable or increased for women. Furthermore, the application of radiotherapy increased in patients with high-staged cancer, but five-year relative survival rates remained stable for glottic and supraglottic cancer. So, while progress has been made in some respects, The Netherlands has seen little improvement in laryngeal cancer survival.