ABSTRACT
Objectives: Thyroid cancers with low T-stage and nodal burden
are common incidental findings at autopsy; however, less is known about
the frequency of non-thyroid head and neck cancers diagnosed at autopsy.
It is important to identify the prevalence of various head and neck
cancers found at autopsy and their association with morality as cancers
differ in risk factors and severity.
Design : Head and neck cancers excluding cutaneous malignancy
were identified in the Surveillance, Epidemiology, and End Results
database. Case-related data was reviewed to characterize the demographic
factors associated with the head and neck cancers found at autopsy.
Fisher’s Exact Test was used to identify correlations between
cancer-related mortality and cancer type.
Results: We reviewed 678 cases of head and neck cancers
diagnosed at autopsy from 2000 to 2017. The most common causes of death
found at autopsy in non-thyroid carcinoma were cancer-related mortality
(51.40%), heart disease (14.95%), and accidents (5.61%). Thyroid
carcinoma was the cause of death in 17 (3.01%) patients. The top three
causes of death in this group were heart disease (26.19%), accident
(9.20%), and infection (6.19%). Patients with non-thyroid cancer were
17.1 (95% CI: 9.55 - 30.6, p < 0.001) times more likely to
have cancer-related death than those with thyroid carcinoma.
Conclusion : The high rate of cancer-related deaths in
postmortem diagnosis of non-thyroid head and neck cancers reveals the
need for physicians to increase detection vigilance and emphasizes the
need to improve screening in those who may be high risk for disease
development or progression.
Key Words : head and neck neoplasm, autopsy, laryngeal neoplasm,
thyroid neoplasm, early detection of cancer