Burden, Trends, and Risk Factors of Other Pharyngeal Cancers in South Asia, 1990-2023: A Secondary Analysis of Global Burden of Disease Study 2023

Introduction and aims South Asia bears the heaviest burden of other pharyngeal cancers in Asia, including cancers of the oropharynx (International Classification of Diseases, Tenth Revision: C09-C10) and hypopharynx (International Classification of Diseases, Tenth Revision: C12-C13), yet systematic analyses remain limited. This study quantifies the evolving burden and attributable risks of other pharyngeal cancers in the region. Methods Using data from the Global Burden of Disease Study 2023 (GBD 2023), this secondary analysis assessed age- and sex-specific other pharyngeal cancer burden and risk-attributable burden in South Asia from 1990 to 2023. Temporal trends were assessed using joinpoint regression, and age-period-cohort modelling was used to characterize age, period, and cohort patterns. Results In 2023, GBD 2023 estimated 81,600 new other pharyngeal cancer cases, 61,400 deaths, and 1.91 million DALYs in South Asia. The region had the highest estimated age-standardized rates in Asia, and Bangladesh had the highest burden within South Asia. After 2015, marked increases in age-standardized incidence, mortality, and DALY rates were estimated in South Asia. While the burden was concentrated among middle-aged and older males, the 15 to 49 age group had the fastest estimated growth. The 1994 birth cohort had an estimated incidence rate ratio of 2.11 relative to the 1949 reference cohort. Smoking and chewing tobacco accounted for the largest proportions of risk-attributable burden among males and females, respectively. Since 2019, the burden attributable to the assessed risk factors has increased sharply. Conclusion GBD 2023 estimates indicate that South Asia had the highest burden of other pharyngeal cancers in Asia, with increasing trends and major attributable burdens from smoking and chewing tobacco. Clinical relevance These findings may inform other pharyngeal cancer prevention, tobacco/alcohol risk reduction, dental public health planning, and regional health-policy planning in South Asia.