Abstract
OBJECTIVE:To analyse recent trends in oral cancer mortality, focusing specifically on differences concerning gender and race.METHODS:Official information on deaths and population in the city of Sao Paulo, 2003 to 2009, were used to estimate mortality rates from oral cancer (C00 to C10, International Classification of Diseases, 10th Revision), adjusted for age and stratified by gender (females and males) and race (blacks and whites). The Prais-Winsten auto-regression procedure was used to analyse the time series.RESULTS:During the study period, 8,505 individuals living in the city of Sao Paulo died of oral cancer. Rates increased for females (rate of yearly increase = 4.4%, 95%CI 1.4;7.5), and levelled off for men, which represents an inversion of previous trends among genders in the city. Increases were identified for blacks, with a high rate of yearly increase of 9.1% (95%CI 5.5;12.9), and levelled off for whites. Oral cancer mortality in blacks almost doubled during the study period, and surpassed mortality in whites for almost all categories.CONCLUSIONS:Mortality presented a higher increase among women than in men, and it doubled among backs. The surveillance of trends of oral cancer mortality across gender and racial groups may contribute to implementing socially appropriate health policies, which concurrently reduce the burden of disease and the attenuation of unfair, avoidable and unnecessary inequalities in health.
Highlights
Oral cancer is a generic term that encompasses epithelial malignancies originating from any part of the mouth or the oropharynx
The surveillance of trends of oral cancer mortality across gender and racial groups may contribute to implementing socially appropriate health policies, which concurrently reduce the burden of disease and the attenuation of unfair, avoidable and unnecessary inequalities in health
Examples include long term exposure to sunshine, which has been acknowledged as being associated with a higher risk of lower lip cancer as well as HPV infection, which has been attributed as a factor for oropharyngeal cancer, especially among young adults.[6,13]
Summary
Oral cancer is a generic term that encompasses epithelial malignancies originating from any part of the mouth or the oropharynx. Almost all of these tumours are squamous cell carcinoma. Despite the important role played by genetic factors in carcinogenesis, oral cancer is overwhelmingly influenced by environmental and behavioural risk factors,[6] tobacco and alcohol consumption being the most relevant in order to explain its occurrence.[13] Existing evidence allows it to be estimated that more than 70% of cases might have been avoided by lifestyle changes, including diet, smoking and drinking habits.[26] These behaviours, in conjunction with viral infection and occupational and environmental exposures, account for a major proportion of these tumours.[13] Examples include long term exposure to sunshine, which has been acknowledged as being associated with a higher risk of lower lip cancer as well as HPV infection, which has been attributed as a factor for oropharyngeal cancer, especially among young adults.[6,13]
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