The mortality from laryngeal cancer in men has fallen by around 60 percent in Spain, decreasing from 12.10 to 4.76 deaths per 100,000 inhabitants. In contrast, among women, deaths have decreased in the younger ones, but have clearly increased from the age of 55.
These conclusions come from a national study published in "Acta Otorrinolaringológica Española," which examines the evolution of mortality between 1999 and 2023. Based on the records of the National Institute of Statistics (INE), the work counts 36,598 deaths from laryngeal cancer in Spain over those 25 years, of which 34,532 corresponded to men (94%) and 2,066 to women (6%).
The authors highlight the close relationship between the dynamics of this tumor and the variations in the population's exposure to risk factors in recent decades, with a special emphasis on tobacco.
"The data clearly shows that changes in tobacco consumption habits of different generations are reflected decades later in mortality from laryngeal cancer," said the president of SEORL-CCC, Serafín Sánchez.
"The favorable evolution observed in men is good news, but the increase we are seeing in older women reminds us that the effects of smoking can appear many years after exposure and that prevention must remain a priority," Sánchez explained.
In men, the decline in mortality has been continuous throughout the period. The standardized rate fell from 12.10 deaths per 100,000 inhabitants in 1999 to 4.76 in 2023, representing an average annual reduction of 4 percent. Among those under 50 years old, the trend was even more marked, with a drop from 1.31 to 0.11 deaths per 100,000 inhabitants and an annual reduction of 11 percent.
The statistical analysis shows that this decline is not only explained by a specific period but also by a clear cohort effect. In men, the risk of death has progressively decreased in the more recently born generations: the estimated relative risk fell from 3.27 in the 1919 cohort to 0.05 in the 1984 cohort.
According to researchers, this pattern fits especially with the lower exposure to tobacco among younger generations. The work points out that other elements, such as advances in diagnosis and treatment, may also have contributed to the improvement, although they consider that the determining factor for the decline in men is the lower incidence of the tumor linked to the reduction of the main risk factors.
A different evolution in women
In women, the panorama is different. Although overall mortality remains low and without major changes, the analysis by age groups reveals opposing trajectories. Among those under 50 years old, deaths significantly decreased between 1999 and 2023, with an average annual decline of 7.2 percent. However, in women aged 50 and older, an annual increase of 1.5 percent was observed.
The Age-Period-Cohort model used in the study allows for further refinement of these differences. Starting from approximately 55 years old, a change in trend is detected, with annual increases in mortality reaching 4.13 percent in the group aged 60 to 64 years and 4.51 percent among women aged 65 to 69 years.
The authors link this behavior to the history of tobacco and alcohol consumption among Spanish women. The massive incorporation of the female population into smoking occurred later than in men, so the consequences of that exposure would now be manifesting, decades later, in the cohorts that are reaching advanced ages.
However, the authors of the work insist that these results should be read with caution, as the absolute number of deaths in women remains low: just over 2,000 deaths compared to more than 34,500 in men over the 25 years studied.
Tobacco and alcohol: key risk factors
Specialists remind that laryngeal cancer is closely linked to avoidable risk factors. Tobacco is the main implicated agent, while alcohol consumption can act synergistically, significantly increasing the likelihood of developing the tumor when both habits coincide.
For this reason, the experts from SEORL-CCC emphasize that prevention remains an essential tool to reduce incidence and mortality. The reduction of tobacco and alcohol consumption must be accompanied by support measures for quitting smoking and enhanced monitoring of those groups that maintain a high exposure to these factors.
"That male mortality has decreased so significantly demonstrates that changes in risk factors can have a huge impact on the health of the population, even if their effects manifest in the long term," Sánchez added.
"At the same time, the evolution observed in older women should serve as a wake-up call to strengthen prevention measures and not let our guard down against smoking," he highlighted.
The study also reminds that the long latency between tobacco exposure and the onset of laryngeal cancer means that variations in consumption patterns do not immediately translate into changes in mortality. For this reason, preventive policies must be sustained for decades.
Finally, SEORL-CCC emphasizes the need to seek consultation for persistent symptoms related to the larynx, especially in people with risk factors. It points out that a change in voice or a hoarseness that does not go away, difficulties swallowing, persistent throat pain, a sensation of a foreign body, respiratory problems, or the appearance of a lump in the neck are signs that should be evaluated by a specialist if they persist over time.
The experts stress that early diagnosis allows for proposing, depending on the characteristics of each patient, treatments aimed at both controlling the disease and preserving, as much as possible, essential functions such as voice and swallowing.