Global Burden of Geriatric Head and Neck Cancer: A Comprehensive Analysis of Epidemiology and Risk Factors from 1990 to 2021

Background Head and neck cancer (HNC) presents an increasing public health concern among the elderly. This study investigated global trends, regional disparities, and risk factors associated with geriatric HNC from 1990 to 2021. Methods A descriptive epidemiological analysis was conducted using data from the Global Burden of Disease (GBD) 2021 study. Age-standardized rates (ASRs) and estimated annual percent changes (EAPCs) were calculated for incidence, mortality, and disability-adjusted life years (DALYs). Regional trends were evaluated using Joinpoint regression and inequality indices, while Bayesian models projected future trends to 2050. Risk factor contributions were also assessed. Results From 1990 to 2021, global incidence of geriatric HNC more than doubled, with a modest increase in ASIR (from 46.29 to 47.96 per 100,000; EAPC: 0.26). Mortality declined (ASMR from 33.90 to 29.24; EAPC: − 0.39). The elderly accounted for over 51% of global HNC cases, with laryngeal cancer showing the highest elderly proportion (59.39%). South Asia, Central Europe, and high-income North America exhibited the highest ASIRs. Smoking, alcohol use, and occupational exposures were major contributors to the disease burden, especially in laryngeal and oral cancers. Projections suggest declining mortality but rising incidence in specific cancer subtypes by 2050. Conclusions Although mortality among elderly HNC patients is decreasing, incidence remains substantial. Prevention strategies tailored by region and cancer subtype—particularly those addressing tobacco and alcohol exposure—are urgently needed.