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.