The Association between Patient’s Age and Head and Neck Cancer Treatment Decision—A Population-Based Diagnoses-Related Group-Based Nationwide Study in Germany

SIMPLE SUMMARY: The impact of the patient’s age on head and neck cancer (HNC) treatment decision has rarely been studied worldwide. Older age cohorts account for a high proportion of HNC patients and might influence the inpatient treatment decision (surgery, radiotherapy, chemotherapy/biologicals). This population-based study in Germany between 2005 and 2018 included data of 1,226,357 HNC cases. Negative binomial regression was performed to study the time-trend analysis on treatment decision. Older age cohorts (≥65 to <80 years and ≥80 years) predominantly have led to an increase in the treatment rates (biopsy, surgery, radiotherapy, chemotherapy/biologicals), younger ones (≥35 to <50 years and ≥50 to <65 years) to a decrease. ABSTRACT: Investigations on the association between patient’s age and head and neck cancer (HNC) treatment decision are sparse. Nationwide diagnoses-related group-based data of 1,226,357 cases hospitalized with primary HNC in Germany from 2005 to 2018 were included. Negative binomial regression was performed to study the development of the treatment rates over time. For all treatment options, i.e., biopsies, surgery, radiotherapy, and chemotherapy/biologicals, increases in the treatment rates were seen in patients >80 years (surgery: oral cavity: relative risk [RR]: 1.2, CI: 1.13–1.20; oropharynx: RR: 1.2, CI: 1.15–1.34; hypopharynx: RR: 1.1, CI: 1.02–1.17; larynx: RR: 1.1, CI: 1.04–1.12; radiotherapy: oral cavity: RR: 1.1, CI: 1.07–1.23; oropharynx: RR: 1.3, CI: 1.16–1.49; hypopharynx: RR: 1.3, CI: 1.21–1.46; larynx: RR 1.2, CI: 1.03–1.29; chemotherapy: oral cavity: RR: 1.2, CI: 1.06–1.31; salivary glands: RR: 1.3, CI: 1.09–1.50; oropharynx: RR: 1.4, CI: 1.12–1.83; hypopharynx: RR: 1.3, CI: 1.06–1.48; larynx: RR: 1.3, CI: 1.08–1.52, all p < 0.05). Older age cohorts (≥80 years) need more awareness as they are mainly responsible for the increase in the rates of surgery, radiotherapy, and chemotherapy/biologics in HNC patients.