Head and neck cancers survival in Europe, Taiwan, and Japan: results from RARECAREnet Asia based on a privacy-preserving federated infrastructure

Front Oncol. 2023 Sep 13:13:1219111. doi: 10.3389/fonc.2023.1219111. eCollection 2023.

Abstract

Background: The head and neck cancers (HNCs) incidence differs between Europe and East Asia. Our objective was to determine whether survival of HNC also differs between European and Asian countries.

Methods: We used population-based cancer registry data to calculate 5-year relative survival (RS) for the oral cavity, hypopharynx, larynx, nasal cavity, and major salivary gland in Europe, Taiwan, and Japan. We modeled RS with a generalized linear model adjusting for time since diagnosis, sex, age, subsite, and histological grouping. Analyses were performed using federated learning, which enables analyses without sharing sensitive data.

Findings: Five-year RS for HNC varied between geographical areas. For each HNC site, Europe had a lower RS than both Japan and Taiwan. HNC subsites and histologies distribution and survival differed between the three areas. Differences between Europe and both Asian countries persisted even after adjustments for all HNC sites but nasal cavity and paranasal sinuses, when comparing Europe and Taiwan.

Interpretation: Survival differences can be attributed to different factors including different period of diagnosis, more advanced stage at diagnosis, or different availability/access of treatment. Cancer registries did not have stage and treatment information to further explore the reasons of the observed survival differences. Our analyses have confirmed federated learning as a feasible approach for data analyses that addresses the challenges of data sharing and urge for further collaborative studies including relevant prognostic factors.

Keywords: federated learning approach; geographical differences; head and neck cancers; population-based cancer registry; survival.

Grants and funding

The Taiwan cancer registry was funded by the Health Promotion Administration, Ministry of Health and Welfare of Taiwan, grant no. A1101009: Tobacco Health and Welfare Taxation. TM and HC were supported for the present manuscript and received grants from the “Health and Labor Sciences Research Grant (20EA1026)”. FM was supported for the present manuscript by the “Netherlands Comprehensive Cancer Organisation”. This research was funded by the Italian Ministry of Health “Ricerca Corrente” funds. The funders had no role in study design, data collection and analysis, interpretation of data, writing of the report, and the decision to submit the paper for publication.