National trends in inpatient incidence of head and neck cancer and anatomic subsites in the United States, 2018 to 2022.

Abstract

e23233 Background: Inpatient hospitalizations for head and neck cancer (HNC) reflect severe disease, treatment-related complications, and advanced oncologic care. While population-based cancer incidence is well described, national trends in inpatient HNC incidence, particularly by anatomic subsite across the COVID-19 era, remain poorly characterized. Methods: A survey-weighted analysis of the Healthcare Cost and Utilization Project National Inpatient Sample (NIS), 2018 to 2022, was performed to generate nationally representative estimates. Hospitalizations with a principal diagnosis of HNC were identified using ICD-10-CM codes C00 to C06 (oral cavity), C07 to C08 (salivary gland), C09 to C10 (oropharynx), C11 (nasopharynx), C12 to C13 (hypopharynx), C30 to C31 (sinonasal), C32 (larynx), and C14 or C76.0 (other or ill-defined). Thyroid cancer (C73) was excluded. Inpatient incidence was defined as hospitalizations or discharges. Unweighted NIS counts and survey-weighted national estimates were reported by calendar year and anatomic subsite. Results: From 2018 to 2022, the NIS contained 33,204 unweighted HNC hospitalizations, corresponding to a weighted national estimate of 166,020 hospitalizations (95% CI 158,702 to 173,338). Annual weighted inpatient incidence remained stable, ranging from approximately 31,800 to 34,500 hospitalizations per year. Unweighted annual counts were 6,509 (2018), 6,805 (2019), 6,357 (2020), 6,636 (2021), and 6,897 (2022), with corresponding weighted estimates of 32,545, 34,025, 31,785, 33,180, and 34,485 hospitalizations. By subsite, oral cavity cancer represented the largest inpatient burden, accounting for 40.6% of unweighted cases and approximately 67,260 weighted hospitalizations. Laryngeal cancer was the second most common subsite (21.3% unweighted; approximately 35,145 weighted hospitalizations), followed by oropharyngeal cancer (13.5% unweighted; approximately 22,450 weighted hospitalizations). Less common subsites included salivary gland (6.9%), sinonasal (4.7%), hypopharyngeal (3.6%), nasopharyngeal (2.4%), and other or ill-defined HNC (7.1%). Across subsites, inpatient incidence patterns were generally stable over time, with a modest decline in 2020 followed by recovery in 2021 to 2022. This pattern was consistent for oral cavity, laryngeal, and oropharyngeal cancers. Conclusions: From 2018 to 2022, national inpatient incidence of head and neck cancer remained stable, with a transient decline during 2020 consistent with COVID-19–related healthcare disruption. Oral cavity and laryngeal cancers accounted for most inpatient HNC hospitalizations, highlighting their disproportionate inpatient burden. These findings provide contemporary national benchmarks for inpatient HNC incidence by subsite and emphasize the distinction between inpatient disease burden and population cancer incidence.