Context and epidemiological burden in Indonesia

In Indonesia, the management of head and neck cancers has historically been hindered by a lack of representative epidemiological data at a national scale. This secondary analysis, based on modeled data from GLOBOCAN 2024 (July 2026 version), aims to precisely quantify the burden of six major tumor sites, including the oral cavity (C00–C06), salivary glands, oropharynx, nasopharynx, hypopharynx, and larynx. The study evaluates incidence, mortality, and sex-related disparities, while projecting the demographic evolution of these pathologies through 2050.

The clinical challenge is considerable: for the year 2024, the burden is estimated at 28,226 new cases and 16,025 deaths, showing age-standardized incidence rates (ASIR) of 8.91 and mortality rates (ASMR) of 5.06 per 100,000 inhabitants. Nasopharyngeal carcinoma largely dominates the clinical picture, accounting for 56.9% of cases (16,064) and 54.4% of the total mortality for the group.

The objective is to support prevention strategies and hospital planning in the face of a massive growth hypothesis linked to demographic transition. At constant rates, projections anticipate a +66.1% increase in cases and +74.1% in deaths by 2050. These data highlight the urgency, for the practitioner and health authorities, to strengthen registries and specialized care infrastructures.

Methodology: Secondary analysis of GLOBOCAN 2024 modeled data

This study is a descriptive secondary analysis based on aggregated modeled estimates from the GLOBOCAN 2024 database (version of July 08, 2026). The primary objective was to estimate incidence, mortality, sex-related disparities, and demographic projections for six specific groups of upper aerobic and digestive tract (UADT) cancers in Indonesia.

The protocol included data collection and aggregation for mutually exclusive anatomical sites, defined according to the International Classification of Diseases (ICD-10) codes:

• Oral cavity and lips: codes C00–C06.
• Salivary glands: codes C07–C08.
• Oropharynx: codes C09–C10.
• Nasopharynx: code C11.
• Hypopharynx: codes C12–C13.
• Larynx: code C32.

Researchers analyzed case numbers and age-standardized rates for incidence (ASIR) and mortality (ASMR). To put the Indonesian data into perspective, a descriptive comparison was performed with four reference populations. Furthermore, projections to 2050 were carried out via the Cancer Tomorrow tool, using constant-rate models. Data reliability was subjected to 21 validation checkpoints. It should be noted that the absence of uncertainty distributions in the original source did not allow for the construction of confidence intervals.

Epidemiological burden and prevalence of nasopharyngeal carcinoma

Analysis of the GLOBOCAN 2024 modeled data for Indonesia reveals a substantial burden of head and neck cancers. For the year 2024, the study estimates a total of 28,226 new cases and 16,025 deaths related to the six selected anatomical sites. The overall age-standardized incidence rate (ASIR) stands at 8.91 per 100,000, while the age-standardized mortality rate (ASMR) is 5.06 per 100,000.

Nasopharyngeal carcinoma (C11) appears as the dominant pathology, accounting for more than half of the total morbidity and mortality burden in this region:

• Incidence of nasopharyngeal cancer: 16,064 cases, representing 56.9% of all studied locations.
• Nasopharyngeal cancer mortality: 8,718 deaths, representing 54.4% of the total.

Gender disparities

Data highlight a significantly higher prevalence in men. Male incidence and mortality rates are more than double those observed in women.

Note: The authors specify that uncertainty distributions for the sources were not available, preventing the construction of confidence intervals or calculations of statistical significance (p-values) for these modeled estimates.

Demographic projections for 2050

By maintaining the 2024 incidence rates constant, projections based on the demographic evolution of the Indonesian population predict a massive increase in the oncological burden by 2050:

• New annual cases: increase to 46,895 cases, representing a 66.1% increase.
• Annual deaths: increase to 27,900 deaths, representing a 74.1% rise.

The study highlights that these figures reflect only the impact of demographic change and do not take into account potential modifications in risk factors or improvements in detection systems.

Clinical analysis: The predominance of nasopharyngeal carcinoma

The results of this secondary analysis of GLOBOCAN 2024 data reveal a unique epidemiological reality: nasopharyngeal cancer (NPC) alone accounts for 56.9% of cases and 54.4% of deaths related to head and neck cancers in Indonesia. Clinically, this massive predominance, coupled with a significantly higher incidence in men (ASIR of 13.19 compared to 5.18 for women), dictates increased diagnostic vigilance for this specific localization in the region.

Limits and methodological framework

The study is based on modeled estimates rather than an exhaustive field census. The authors highlight the absence of data crucial for the practitioner: the stage at the time of diagnosis, actual survival rates, applied treatment protocols, and associated costs. Furthermore, the unavailability of uncertainty distributions from the sources limits statistical precision, preventing the construction of robust confidence intervals.

Future perspectives and challenges

The most alarming point remains the demographic projection. At constant rates, Indonesia will face a 66.1% increase in the annual number of cases and a 74.1% increase in deaths by 2050. This finding highlights the urgency of strengthening national registries and targeted prevention strategies. For the surgical oncologist, this foreshadows increased pressure on healthcare infrastructures and a necessity to standardize early management, particularly for NPC, which constitutes the major burden of the specialty in Indonesia.

Summary of results

This analysis of GLOBOCAN 2024 data reveals a heavy epidemiological burden in Indonesia with 28,226 new cases and 16,025 deaths for the six ENT locations studied. Nasopharyngeal carcinoma massively dominates the clinical picture (56.9% of cases and 54.4% of deaths), preferentially affecting men with a standardized incidence rate of 13.19 compared to 5.18 per 100,000 in women. By 2050, demographic projections predict an explosion in incidence (+66.1%) and mortality (+74.1%).

In concrete terms, for the practitioner:

• Priority for nasopharyngeal screening: Strengthen vigilance regarding warning signs (cervical lymphadenopathy, unilateral otological symptoms), particularly in male patients who present a 2.5 times higher risk.
• Systematic clinical examination: Integrate the screening of oral cavity and oropharynx lesions into every routine assessment to reduce mortality, which remains higher than 50% of diagnosed cases.
• Long-term planning: Anticipate a drastic increase in oncological care and head and neck reconstruction needs in your practice, driven by Indonesian demographic trends by 2050.

Study lexicon

ASIR (Age-Standardized Incidence Rate): Age-standardized incidence rate per 100,000 person-years. This statistical indicator allows for the comparison of incidence data between populations with different age structures, such as Indonesia and the reference populations cited in the analysis.

ASMR (Age-Standardized Mortality Rate): Age-standardized mortality rate. Like the ASIR, it adjusts observed deaths to neutralise the influence of the age pyramid, thereby facilitating the comparative assessment of the actual burden of ENT cancer mortality.

Nasopharyngeal carcinoma (C11): Malignant neoplasm localized in the nasopharynx. In this study, it represents the predominant anatomical site, contributing to 56.9% of cases and 54.4% of deaths among the six selected head and neck cancer groups in Indonesia.

GLOBOCAN 2024: Database from the International Agency for Research on Cancer (IARC) providing modeled estimates of cancer incidence and mortality. The study constitutes a descriptive secondary analysis of these aggregated data for Indonesia.

Cancer Tomorrow Projections: Predictive modeling tool used by the authors to estimate the increase in the annual number of cases and deaths by 2050, by maintaining 2024 rates constant while accounting for demographic changes.

C00–C06 site groups (Lip and oral cavity): Classification grouping cancers of the lip and oral cavity. It is one of the six mutually exclusive site groups analyzed, also including the salivary glands, oropharynx, nasopharynx, hypopharynx and larynx.

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