The Burden and Risk Factors of Head and Neck Cancers in G20 Countries, 1990-2023.

BACKGROUND: Head and neck cancers (HNC) rank as the sixth most common cancers globally, yet comprehensive epidemiology among the Group of Twenty (G20) nations is lacking. METHODS: This secondary analysis of Global Burden of Disease 2023 data systematically assessed the spatiotemporal trends, population disparities and risk-attributable burden (excluding viral factors) of age-standardised rates for HNC across G20 countries. Future trends were forecast using an autoregressive integrated moving average (ARIMA) model. RESULTS: In 2023, lip and oral cavity cancer (LOCC) presented the highest burden among HNC subtypes across the G20, with an age-standardised incidence rate (ASIR) of 4.52 per 100,000, corresponding to 283,441 new cases. India carried the highest burden of LOCC, China that of nasopharyngeal carcinoma (NPC) and France that of laryngeal and other pharyngeal cancers (LC/OPC). From 1990 to 2023, LOCC and OPC incidence rose overall while LC and NPC declined. South Korea showed the fastest NPC increase, while the United Kingdom had the steepest rise in LOCC/OPC. China recorded the most significant reductions in NPC age-standardised mortality and disability-adjusted life year rates (ASMR and ASDR), whereas France showed the sharpest decline in LOCC/OPC. Indonesia was the sole country with consistent increases across all subtypes. Although males are predominantly affected, female incidence was higher for NPC in the United Kingdom and for LOCC/OPC in Saudi Arabia. The HNC burden concentrates in elderly populations, with tobacco and alcohol as leading risk factors, though their contributions vary by country and sex. Projections to 2038 indicate likely increases in OPC and NPC incidence, with LOCC remaining the predominant contributor. CONCLUSION: Marked regional, sex and age disparities in HNC burden and risk factors exist across G20 nations. CLINICAL RELEVANCE: These disparities provide an evidence base to mobilise health-development assistance and to design precise, differentiated transnational control strategies.