Throat cancer deaths are declining in the United States, but some groups are faring better than others, a new study finds.

Death rates are decreasing among people with at least a high school education and those whose cancer is not caused by the human papillomavirus (HPV). However, among white men with less education, and in people with cancer caused by HPV, death rates are either unchanged or increasing, the researchers said.

The recent decline in throat-cancer deaths is likely due to progress in smoking cessation, said study researcher Dr. Amy Chen, of Emory University School of Medicine in Atlanta. However, the new study suggests we need to do more to prevent deaths from this cancer.

"We've hit a plateau in terms of improving mortality rates based on just stopping smoking," Chen said.

Factors such as a person's access to health care could be affecting their survival.

Throat-cancer death rates

Chen and colleagues analyzed findings from the National Center for Health Statistics on white and black men and women, aged 25-to-64 years, in 26 states. They examined death rates from mouth and throat cancer in these groups.

Between 1993 and 2007, death rates from mouth and throat cancers decreased by close to 5 percent among black men who graduated from high school and about 3.7 percent among black women who were high school graduates.

Death rates among white men and women who graduated from high school also went down over this time period but the trend was not as dramatic and could have been due to chance, the researchers said.

In contrast, among white men who didn't graduate from high school, death rates from these cancers rose 6.8 percent between 1995 and 2002 and then stabilized, the researchers said.

And in white men as a group, death rates from these cancers increased close to 2 percent, regardless of education level. This finding is consistent with previous studies that have found an increase in HPV-related cancers among white men under 60.

Explaining the trends

Education level can indicate socioeconomic status, Chen said — people who attain a high level of education are more likely to have a job, health insurance and access to care. For this reason, those with more education may have their cancers diagnosed earlier and have a better prognosis.
In addition, "progress in reducing smoking prevalence has been much larger in the most educated than the least educated persons," the researchers wrote in the November issue of the journal Archives of Otolaryngology—Head & Neck Surgery.

For example, 26.7 percent of people with less than 12 years of education were smoking in 2006, while 9.6 percent of those with 16 or more years of education were smoking that year, the researchers said.

Oral sex is the major risk factor for developing a mouth and throat cancer that is caused by HPV, the researchers said.

"The increase in HPV-related oral cavity and [throat] cancers among white men may reflect racial differences and changing patterns of sexual behaviors," the researchers said. One study found white men aged 15 to 19 were three times more likely to engage in oral sexual activity compared with black men, the researchers said.

The study of HPV-related head and throat cancers is still in its infancy and more research is needed to understand what makes these cancers behave differently, Chen said.

Pass it on: Death rates from mouth and throat cancer vary depending on education level and whether the cancer is caused by HPV.