INCIDENCE RATES OF ORAL AND OROPHARYNGEAL CANCER IN SOUTH AFRICA 1988-2013

Abstract

In South Africa, the four different population groups (White, Black, Coloured/Mixed Race and Asian) have very different incidence rates of oral cancers. The possible impact of HR-HPV infection on the incidence of oropharyngeal cancer in this country has not been assessed. Objectives To describe and compare the trends in age standardised incidence rates (ASIR) of oral and oropharyngeal cancer in South Africa from 1988 to 2013. Methods The ASIRs of these cancers were calculated from the incidence rates published by the National Cancer Registry (SA-NCR), a pathology-based registry. Findings The average ASIR (/100,000/year) of oral cavity cancer for all males was 5.9 and for all females 1.74; the highest affected were the males of mixed race (8.47) and white males (6.19) and the Asian females (4.61). The latter population group is known for a high consumption of Areca nut. The average ASIR of pharyngeal cancer for all males was 2.61 and for all females 0.71; The highest incidence of pharyngeal cancer was noted in the males of mixed race (3.86) and white males (2.73). As South Africa is not known for a high incidence of nasopharyngeal cancer, these rates would more or less apply to oropharyngeal cancers. The trends of oral cavity and oropharyngeal cancer ASIRs over the period 1988-2013 show a slight downward trend except for white and mixed-race females. The incidence trends in pharyngeal cancer also show a decline over that period. Conclusion The intensification of the anti-tobacco legislation and campaigns in South Africa might have contributed to the slightly declining incidences of oral and pharyngeal cancer. Contrary to data reported in the United States and Europe, there is no indication of a rise in HR-HPV driven oropharyngeal cancers over the period 1998-2013 which could indicate that South Africa is lagging behind in the HR-HPV related carcinoma epidemic.