Lt. Col. Anna Maruska, 55th Operational Medical Readiness Squadron flight surgeon, performs a neck and throat exam on 1st Lt. Emma Jones, 338th Combat Training Squadron student pilot, at the Ehrling Bergquist clinic June 5, 2025. The neck and throat is examined to check for different conditions such as enlarged lymph nodes, thyroid swelling, and circulatoy problems. (U.S. Air Force photo by Daniel Martinez)
FORT SAM HOUSTON, TX — Active-duty servicemembers who are male, enlisted in the Army and age 40 and older have the highest incidence rates of head and neck cancer, according to a recent study.
The study published in the Medical Surveillance Monthly Report (MSMR) estimated the incidence of head and neck cancer among active component servicemembers (Army, Navy, Air Force, Marine Corps and Coast Guard) from 2010 through 2024.1
This report updates a prior 2021 MSMR analysis of the same population (with the addition of the Coast Guard) from 2007 to 2019 but uses a broader case definition to include all head and neck cancers and extends the surveillance period through 2024. The prior study was restricted to malignant neoplasms of the lip, oral cavity and pharynx.
Study authors are affiliated with Tri-Service Center for Oral Health Studies, Uniformed Services University at Joint Base San Antonio in Fort Sam Houston, TX.
Head and neck cancer, the seventh most common cancer worldwide, is a term for cancers originating in the head and neck region, including the lip, oral cavity, nasal cavity, paranasal sinuses, salivary glands, pharynx and larynx. In 2022, there were more than 940,000 new cases of head and neck cancer and 480,000 fatalities globally. Major risk factors of head and neck cancer include alcohol and tobacco use, betel nut chewing and infection with human papillomavirus (HPV), but additional risk factors include genetics, Epstein-Barr virus infection, radiation therapy, exposure to occupational or environmental carcinogens and immunodeficiency. Signs and symptoms might vary, depending on where the cancer originated in the head and neck region, the investigators pointed out.
While numerous studies have examined the incidence of head and neck cancer among veterans, this cancer type hasn’t been studied often in active component servicemembers because it’s significantly more common among adults 55 and older. The active component military population is generally younger, and this cancer makes up a small part of the cancer burden in this population.
However, the study explained, it is important to understand the incidence of head and neck cancer, because this debilitating disease often isn’t diagnosed until it has metastasized. Also, it can compromise servicemember readiness with significant physical limitations and psychosocial effects that include difficulty chewing, speaking and swallowing, anxiety, depression and social isolation, the authors pointed out.
This study highlights specific high-risk populations among active component servicemembers from 2010 to 2024, but it should be reiterated that individual risk factors (e.g., smoking status, alcohol consumption, HPV status) weren’t evaluated in this study, Lt. Col. Christa E. Goodwin, DMD, MS, ABDPH, a public health dentist and director of the Tri-Service Center for Oral Health Studies at Uniformed Services University, told U.S. Medicine.
Data were obtained from the Armed Forces Health Surveillance Division, the central epidemiological health resource for the U.S. military. The surveillance population included servicemembers in the U.S. Army, Navy, Air Force, Marine Corps and Coast Guard who were diagnosed with head and neck cancer from Jan. 1, 2010, through Dec. 31, 2024.
The study team identified cases using the International Classification of Diseases, 9th and 10th revisions (ICD-9/ICD-10), codes for malignant neoplasms of the lip, oral cavity, pharynx, nasal cavity, larynx and sinuses. The incidence date was the first qualifying hospitalization or outpatient medical encounter with a case-defining head and neck cancer diagnosis. An individual was considered an incident case once per lifetime. Other variables evaluated in the study included branch of service, sex, year of diagnosis and age at diagnosis. Annual incidence rates were calculated for each service branch, sex and age group.
From 2010 to 2024, the authors found there were 549 cases of head and neck cancer diagnosed in the active component military. The Army had the highest 15-year incidence rate (3.3 per 100,000 person-years) compared to the Navy (2.6 per 100,000), Air Force (2.6 per 100,000), Coast Guard (2.0 per 100,000) and Marine Corps (1.3 per 100,000).
Servicemembers who were 40 and older had the highest overall incidence rate (12.3 per 100,000), which was 3.3 times the next highest rate observed among individuals 35 to 39 years old. The male incidence rate (2.9 per 100,000) was greater than the rate among females (1.7 per 100,000). The parotid gland was the most common site of diagnosis, making up 14.8% of cases, the researchers advised.
“I hope this study raises awareness regarding the importance of head and neck cancer prevention education as well as early detection,” Goodwin said. “Head and neck cancer may not be common among active component servicemembers, but it is a debilitating disease that can have a profound impact on quality of life. In addition to evaluating patients for signs of head and neck cancer, clinicians should be educating patients regarding major risk factors of the disease (e.g., tobacco and alcohol use, HPV infection), ways to lower the risk of developing it and symptoms of it.”
“Patients, in addition to clinicians, need to be cognizant of the signs and symptoms so that if cancer is suspected, the process of diagnosis, treatment plan development, etc., can begin as soon as possible. Early detection has a significant impact on the course of treatment as well as outcome,” she added.
This report provides the most current head and neck cancer incidence data for active component servicemembers, establishing baseline rates for monitoring future trends and highlighting specific high-risk populations (e.g., men, Army personnel and servicemembers ages 40 years and older). This information is critical because the incidence of head and neck cancer among active component servicemembers is rarely reported, the investigators suggested.
Early detection is key to improving prognosis of head and neck cancer, along with educating patients about the signs, symptoms and risk factors of this type of cancer, according to the report, which added that military dentists play a significant role in early detection because active component servicemembers are required to have a yearly dental examination, allowing dentists to evaluate patients for suspicious lesions in the head and neck region.
Dentists adhere to the American Dental Association’s “Early Detection and Prevention of Oral and Oropharyngeal Cancer” policy, which recommends cancer prevention education and a routine visual and tactile examination for all patients. However, regular self-examinations for the signs of head and neck cancer are equally important and need to be encouraged among active component servicemembers, the researchers recommended.
- Goodwin CE. Head and neck cancer among U.S. active component service members, 2010-2024. MSMR. 2026 May 15;33(4):10-14. PMID: 42155135.