Abstract
BackgroundDownward trends have been observed in oral cancer incidence and mortality in the US over the past 30 years; however, these declines are not uniform within this population. Several studies have now demonstrated an increase in the incidence and mortality from oral cancers among certain demographic groups, which may have resulted from increased risks or risk behaviors. This study examines the underlying data that comprise these trends, to identify specific populations that may be at greater risk for morbidity and mortality from oral cancers.MethodsOral cancer incidence and mortality data analyzed for this study were generated using the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program.ResultsWhile oral cancer incidence and mortality rates have been declining over the past thirty years, these declines have reversed in the past five years among some demographic groups, including black females and white males. Sorting of these data by state revealed that eight states exhibited increasing rates of oral cancer deaths, Nevada, North Carolina, Iowa, Ohio, Maine, Idaho, North Dakota, and Wyoming, in stark contrast to the national downward trend. Furthermore, a detailed analysis of data from these states revealed increasing rates of oral cancer among older white males, also contrary to the overall trends observed at the national level.ConclusionThese results signify that, despite the declining long-term trends in oral cancer incidence and mortality nationally, localized geographic areas exist where the incidence and mortality from oral cancers have been increasing. These areas represent sites where public health education and prevention efforts may be focused to target these specific populations in an effort to improve health outcomes and reduce disparities within these populations.
Highlights
Downward trends have been observed in oral cancer incidence and mortality in the US over the past 30 years; these declines are not uniform within this population
All oral cancer statistics in this report are based on SEER incidence and National Center for Health Statistics (NCHS) mortality statistics, which consisted of cancers of the oral cavity and pharynx, including the lip, oral cavity and pharynx [22]
Over the past 30 years, oral cancer incidence has declined among white males (-1.21%), white females (-0.66%), black males (-1.53%) and black females (-1.38%), these observed declines have not been uniform across time or demographic groups
Summary
Downward trends have been observed in oral cancer incidence and mortality in the US over the past 30 years; these declines are not uniform within this population. Cancer remains the second leading cause of death in the US [11], and these observed increases in oral cancer provide compelling rationale for this study examining data underlying the general declining trends to elucidate which specific subsets of the population, as well as specific states or regions, that face increasing oral cancer rates. This study demonstrated that oral cancer rates among females, in particular, have increased [13] These data provide some evidence of the disparities in oral cancer rates between these populations, a more detailed examination may identify states, metropolitan areas or communities, as well as additional population sub-groups within these areas, which are experiencing increases in oral cancer incidence or mortality
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