Groundbreaking Study Uncovers Dramatic Rise In Childhood Head And Neck Cancer, And Girls Are Most At Risk

In a striking revelation, a groundbreaking study led by physicians at AdventHealth for Children has uncovered that pediatric head and neck cancer cases are rising dramatically, faster than all other forms of childhood cancer. And girls are disproportionately at risk.  
 
The study – perhaps the largest clinical investigation of pediatric head and neck cancer in the U.S. – highlights a startling shift in the pediatric cancer landscape. Head and neck cancer now accounts for 1 in 6 pediatric cancer diagnoses. 
 
“The data is quite sobering, but it is also quite powerful, because it raises awareness that a potential crisis is happening and that pediatric head and neck cancer must be a focus in the fight against childhood cancer,” said Dr. Joseph Lopez, chief of Pediatric Head & Neck Surgery at AdventHealth for Children in Orlando. “To us, this is a wake-up call.” 
 
Lopez is the first dual fellowship-trained head and neck surgeon and pediatric craniofacial surgeon in the United States and runs one of the country’s only multidisciplinary pediatric head and neck tumor clinics, at AdventHealth for Children in Orlando.
 
Alongside Dr. Fouad Hajjar, medical director of pediatric oncology at AdventHealth for Children, and surgical experts from the Memorial Sloan Kettering Cancer Center in New York, Lopez spearheaded the study – a 20-year retrospective published in Pediatric Blood & Cancer – to track trends across more than 29,000 cases from 2001 to 2019. 
 
It revealed that cases of pediatric head and neck cancer rose significantly over the two-decade span. Even more striking was the gender disparity the research uncovered: About 60% of the cases were girls. 
 
Hajjar called the research “a major breakthrough,” but said it’s still not understood why pediatric head and neck cases are rising, or why girls are at higher risk.  
 
“Studies like this definitely trigger the ‘why’ question and that would be so important to figure out why this is happening,” Hajjar said. “Because if we figure out the why, we can save even more children, not just locally but all over the world. A publication like this can be the spark.” 
 
Despite the rise in cases, there is still a lack of awareness around head and neck cancer among parents, caregivers and even pediatricians. Lopez said many of his patients arrive at his clinic with large, late-stage tumors that have been quietly growing for months, sometimes years.  
 
That was the case for Madi Montanez, a toddler whose cancerous jaw tumor was initially overlooked during her 6-month checkup. “She got a clean bill of health, even though at that point she had to have had the tumor growing in her face,” her father, Michael Montanez, said.  
 
For the next three months, Madi’s tumor was repeatedly overlooked — first brushed off as a harmless bump, then mistaken for a dental infection. All the while, the mass was growing, from a marble-sized lump, into a tumor the size of a golf ball before it was finally detected. Thankfully, Lopez was able to remove it, and Madi went through treatment successfully. 
Still, her case is far from unique. 
 
“Madi’s story is a perfect example of what we typically see in our clinic. She was seen by a pediatrician who, through no fault of their own, was not prompted to think, ‘Oh this kid may have cancer’” Lopez said. “Ultimately, our research raises awareness that we need to be vigilant about lumps and bumps that could be head and neck cancer."