Oral Cancer Mortality Research Articles

Influence of Public Oral Health Services and Socioeconomic Indicators on the Frequency of Hospitalization and Deaths due to Oral Cancer in Brazil, between 2002-2017.

Background: Oral cancer is a frequent neoplasm worldwide, and socioeconomic factors and access to health services may be associated with its risk. Aim: To analyze effect of socioeconomic variables and the influence of public oral health services availability on the frequency of new hospitalized cases and mortality of oral cancer in Brazil. Materials and Methods: This observational study analyzed all Brazilian cities with at least one hospitalized case of oral cancer in the National Cancer Institute database (2002–2017). For each city were collected: population size, Municipal Human Development Index (MHDI), Gini Coefficient, oral health coverage in primary care, number of Dental Specialized Centers (DSC) and absolute frequency of deaths after one year of the first treatment. The risk ratio was determined by COX regression, and the effect of the predictor variables on the incidence of cases was verified by the Hazard Ratio measure. Poisson regression was used to determine factors associated with higher mortality frequency. Results: Cities above 50,000 inhabitants, with high or very high MHDI, more unequal (Gini > 0.4), with less oral health coverage in primary care (<50%) and without DSC had a greater accumulated risk of having 1 or more cases (p < 0.001). Higher frequency of deaths was also associated with higher population size, higher MHDI, higher Gini and lower oral health coverage in primary care (p < 0.001). Conclusions: The number hospitalization and deaths due to oral cancer in Brazil was influenced by the cities’ population size, the population’s socioeconomic status and the availability of public dental services.

Trends in mortality rates for oral and oropharyngeal cancer in Spain, 1979-2018.

To analyse mortality rate trends in Spain for oral cavity and oropharyngeal cancer (OCOPC) from 1979 to 2018, evaluating differences between oral cavity cancer (OCC) and oropharyngeal cancer (OPC). Death certificates and mid-year population data were collected from the Spanish National Statistics Institute. Age-standardized mortality rates were calculated using the direct method. Joinpoint regressions were used to identify significant changes in mortality trends. Independent effects of age, period and cohort (APC) were estimated. A total of 52,057 deaths were registered from OCOPC, 38,988 from OCC and 13,069 from OPC between 1979 and 2018. While OCC mortality rates declined, OCOPC rates increased slightly and OPC significantly. OCC and OPC mortality reached their highest values between 1979 and 1992, when OCC rates began to decrease in males and OPC levelled off until 2018. Lip cancer suffered the highest drop. APC models showed a mortality increase in males and females from 40 to 45 and 50 to 55years of age, respectively. Favourable OCC mortality trends was plausibly influenced by decreased tobacco/alcohol consumption, while OPC rise was probably associated with increased human papillomavirus infection. The importance of closely monitoring these cancers by age group, sex and location, and continuing with preventive measures against known risk factors, is highlighted.

Oral and oropharyngeal cancer mortality in Brazil, 1983-2017: Age-period-cohort analysis.

To estimate the effect of age, period, and birth cohort on mortality from oral and oropharyngeal cancer in Brazil. Deaths due to oral and oropharyngeal cancer from 1983 to 2017 were analyzed. The effect of age, period, and cohort was calculated using the Poisson regression model. Between 1983 and 2017, 142,634 deaths were recorded from oral and oropharyngeal cancer in Brazil, 54% from oropharyngeal cancer. The male sex contributed to 81% of the deaths. The average mortality rate for men was 4.5 deaths per 100,000 inhabitants, and for women, it was 0.9 deaths per 100,000 inhabitants. There was a strong effect of age on mortality rates from oral and oropharyngeal cancer. The risk increases from 40years of age in men and 55years of age in women. An overall period effect was observed. The 2000 period showed the greatest risk when compared to the 1985 period in men. In women, the period of highest risk was 2010. The cohorts born between 1958 and 1962 had a higher risk of death. The period effect is mainly attributed to mortality from oropharyngeal cancer. Most significant values regarding the effect on the cohort groups were observed in female mortality from oral cancer.

Oral Cancer Awareness Among Undergraduate Dental Students of Kantipur Dental College and Hospital.

Oral Cancer is one of the most common form of cancer in the world. The early diagnosis and identification of cancerous lesions are necessary to reduce the morbidity and mortality of oral cancer. Today's dental students are tomorrow's dental surgeons and specialists who identify and manage the oral cancer patients. The aim of the study is to assess the knowledge and attitude regarding etiology and clinical features of oral cancer. The study was a descriptive cross-sectional study conducted at Kantipur Dental College, Kathmandu, Nepal after the ethical approval by Kantipur Dental College Institutional Ethical Review Committee. The study population were clinical students from third, fourth and fifth year of Bachelor of Dental Surgery. Out of 101 participants, 67.3% students always examined their patient's oral mucosa. Only 3.0% students felt very well-informed about clinical appearance of oral cancer. Of of total, 54.5% students identified floor of mouth as most common site of oral cancer and 60.4% identified border of tongue as most common site of oral cancer. Of total participants, only 22.8% students had examined oral cancer lesion before the study. Almost all (99%) students reported they wanted lacked knowledge and wanted more information on oral cancer. The undergraduate students lacked knowledge on the identification and detection of oral cancer. They were also not examining patient's oral mucosa routinely. Many students did not have sufficient information on risk factors and associated oral cancer lesions.

Oral Microbial Species and Virulence Factors Associated with Oral Squamous Cell Carcinoma

The human microbiome has been the focus of numerous research efforts to elucidate the pathogenesis of human diseases including cancer. Oral cancer mortality is high when compared with other cancers, as diagnosis often occurs during late stages. Its prevalence has increased in the USA over the past decade and accounts for over 40,000 new cancer patients each year. Additionally, oral cancer pathogenesis is not fully understood and is likely multifactorial. To unravel the relationships that are associated with the oral microbiome and their virulence factors, we used 16S rDNA and metagenomic sequencing to characterize the microbial composition and functional content in oral squamous cell carcinoma (OSCC) tumor tissue, non-tumor tissue, and saliva from 18 OSCC patients. Results indicate a higher number of bacteria belonging to the Fusobacteria, Bacteroidetes, and Firmicutes phyla associated with tumor tissue when compared with all other sample types. Additionally, saliva metaproteomics revealed a significant increase of Prevotella in five OSCC subjects, while Corynebacterium was mostly associated with ten healthy subjects. Lastly, we determined that there are adhesion and virulence factors associated with Streptococcus gordonii as well as from known oral pathogens belonging to the Fusobacterium genera found mostly in OSCC tissues. From these results, we propose that not only will the methods utilized in this study drastically improve OSCC diagnostics, but the organisms and specific virulence factors from the phyla detected in tumor tissue may be excellent biomarkers for characterizing disease progression.

WHAT IS NEW IN THE EPIDEMIOLOGY OF LIP AND ORAL CANCER ACCORDING TO GLOBOCAN PROJECT 2018?

Lip and oral cancer are one of the most frequent types of cancers in the world. Cultural habits and ethnic variations may influence the epidemiologic profile of patients with this neoplasm. The GLOBOCAN project is updated annually with cancer estimates and statistics around the world. The aim of this review is to compare statistics of lip and oral cancer based on GLOBOCAN 2012 and 2018. The review was conducted using the online platform of data statistics available by International Agency for Research on Cancer. Data not available on the platform were added based on a preview of epidemiology articles about these neoplasms. In 2018, 54 464 more cases were diagnosed compared to GLOBOCAN 2012. Men are more affected than women in all countries, in both projects. One-half of patients died in both projects. Therefore, ethnic variations have great importance on the epidemiologic characterization of oral cancer because cultural habits that lead to more exposure to risk factors increase incidence and mortality of lip and oral cancer. Apoio Financeiro: Fundação de Amparo a Pesquisa do Estado de São Paulo. Lip and oral cancer are one of the most frequent types of cancers in the world. Cultural habits and ethnic variations may influence the epidemiologic profile of patients with this neoplasm. The GLOBOCAN project is updated annually with cancer estimates and statistics around the world. The aim of this review is to compare statistics of lip and oral cancer based on GLOBOCAN 2012 and 2018. The review was conducted using the online platform of data statistics available by International Agency for Research on Cancer. Data not available on the platform were added based on a preview of epidemiology articles about these neoplasms. In 2018, 54 464 more cases were diagnosed compared to GLOBOCAN 2012. Men are more affected than women in all countries, in both projects. One-half of patients died in both projects. Therefore, ethnic variations have great importance on the epidemiologic characterization of oral cancer because cultural habits that lead to more exposure to risk factors increase incidence and mortality of lip and oral cancer. Apoio Financeiro: Fundação de Amparo a Pesquisa do Estado de São Paulo.

Alveolar Bone Loss, Tooth Loss and Oral Cancer Mortality in Older Patients: A Retrospective Cohort Study.

PurposeThere has been growing interest in the association between periodontitis and systemic disease. In recent years, however, inconsistent results have also been found by case–control studies for the role of periodontitis in the development of oral cancer. This study aimed to examine whether periodontitis was an independent risk factor for oral cancer with a ≥75-year age group cohort.Materials and MethodsBetween January 2010 and December 2014, 1385 patients aged ≥75 years who underwent radiographic examination were included in this retrospective cohort study. We collected demographic information and comorbid health conditions from local health authorities. Participants were followed up until either the occurrence of mortality, or the end of the study on December 31, 2018. Cox proportional hazards regression and competing risk hazard models were used to examine the association between periodontitis and oral cancer mortality.ResultsPeriodontitis and loss of teeth were significantly associated with oral cancer mortality. Compared to oral cancer mortality in healthy subjects, the HR and 95% CI in patients with mild, moderate, and severe periodontitis were 4.46 (0.94–21.06), 5.16 (1.14–23.39), and 6.65 (1.51–29.36), respectively. The HR (95% CI) was 1.05 (1.01–1.09) for tooth loss after controlling for potential confounding factors. All the increases in risk persisted in patients aged ≥80 years.ConclusionThe present study provides substantial evidence that poor periodontal health is associated with oral cancer mortality. It is necessary to underline the importance of considering periodontitis in the prevention of oral cancer, particularly in the older patients.

Mortality from oral and oropharyngeal cancer in Brazil, between 2000 and 2013: trends by sociodemographic strata.

Generalized observations of temporal trends in mortality could mask consistent specific patterns. This study aims to analyze the trend of oral and oropharyngeal cancer mortality rates in Brazil, from 2000 to 2013, considering the differences by gender, anatomical site, age group and ethnicity. Data on oral and oropharyngeal cancer mortality were retrieved from the Mortality Information System. The trend of historical series mortality rates by stratum was estimated through a generalized linear regression by the Prais-Winsten method. In total, 61,190 deaths from oral and oropharyngeal cancer were recorded in the 2000-2013 period (mean of coefficients: 3.50 deaths/100 thousand inhabitants/year). The trend of mortality rates was stable for males and increasing for females (1.31%/year). A growing pattern was identified for men aged 20-29 years (2.92%/year) and brown men (20.36%/year). The increasing pattern was also identified for white women (2.70%/year) and brown women (8.24%/year). We can conclude that surveillance of this condition should consider the sociodemographic differences of the population for equitable planning of care strategies because they reflected in different trends of oral and oropharyngeal cancer mortality rates in Brazil.

Bayesian disease mapping and the 'High-Risk' oral cancer population in Hong Kong.

Preventive and early diagnostic methods such as health promotion and disease screening are increasingly advocated to improve detection and survival rates for oral cancer. These strategies are most effective when targeted at "high-risk" individuals and populations. Bayesian disease-mapping modelling is a statistical method to quantify and explain spatial and temporal patterns for risk and covariate factor influence, thereby identifying "high-risk" sub-regions or "case clustering" for targeted intervention. Rarely applied to oral cancer epidemiology, this paper highlights the efficacy of disease mapping for the Hong Kong population. Following ethical approval, anonymized individual-level data for oral cancer diagnoses were obtained retrospectively from the Clinical Data Analysis and Reporting System (CDARS) of the Hong Kong Hospital Authority (HA) database for a 7-year period (January 2013 to December 2019). Data facilitated disease mapping and estimation of relative risks of oral cancer incidence and mortality. A total of 3,341 new oral cancer cases and 1,506 oral cancer-related deaths were recorded during the 7-year study period. Five districts, located in Hong Kong Island and Kowloon, exhibited considerably higher relative incidence risks with 1 significant "case cluster" hotspot. Six districts displayed higher mortality risks than expected from territory-wide values, with highest risk identified for two districts of Hong Kong Island. Bayesian disease mapping is successful in identifying and characterizing "high-risk" areas for oral cancer incidence and mortality within a community. This should facilitate targeted preventive and interventional strategies. Further work is encouraged to enhance global-level data and comprehensive mapping of oral cancer incidence, mortality and survival.

Abstract A116: University of Guam/University of Hawaii Cancer Center Partnership leads areca (betel) nut research in the Pacific Islands

Abstract Areca (betel) nut chewing is the 4th most used psychoactive substance in the world and is chewed by approximately 600 million people in the world. In Monograph 85 (2004), the International Agency for Research on Cancer deemed betel nut chewing with and without tobacco an oral carcinogen. In 2006, the NCI-sponsored University of Guam/University of Hawaii Cancer Center Partnership to Advance Cancer Health Equity began to identify areas in the monograph where research efforts were needed, and thus initiated betel nut research in the Western Pacific. Some countries in this region have reported rates of oral cancer mortality as high as 80% compared to the average worldwide 5-year cumulative of less than 50%. Over the past 12 years, a research framework to study betel nut exposure and oral cancer outcomes has evolved within the partnership. To date, 11 betel nut studies have been funded by this partnership: three molecular studies, three population measures studies, three mechanistic studies, and two prevention studies, including an intervention trial. Of the 11 studies, the majority of the research is focused on the measurement of betel nut exposure and carcinogenicity (55%), followed by the measurement of pathological changes (27%) and the prevention of oral cancer (18%). The partnership's investment has resulted in numerous community collaborations, 18 peer-reviewed publications (13 in population sciences and 5 in basic sciences), and contributions to policy prohibiting the sale of betel nut to minors. Betel nut research faculty are also involved in other federally funded research studies with a betel nut component in the Western Pacific region. The partnership's Betel Nut Research Group will continue to strengthen its research infrastructure, contribute to the scientific literature related to betel nut chewing, expand the research to other health outcomes, and translate the findings into appropriate practices, programs, and policies to control and prevent betel nut-associated cancer and other health outcomes in Pacific Island communities. Citation Format: Yvette C. Paulino, Laura Biggs, Wayne Buente, Francis S. Dalisay, Christine E. Farrar, Adrian Franke, Brenda Y. Hernandez, Ana Joy Mendez, Reinhold Penner, Pallav Pokhrel, Hali Robinett, Jian Yang, Thaddeus A. Herzog. University of Guam/University of Hawaii Cancer Center Partnership leads areca (betel) nut research in the Pacific Islands [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A116.

Polarization gating technique extracts depth resolved fluorescence redox ratio in oral cancer diagnostics.

Mortality of oral cancer is often due to late diagnosis. Effective non-invasive diagnostic techniques may increase the survival rate based on an earlier diagnosis.. We report on the application of the polarization gating technique for isolating weakly scattered and highly scattered components of fluorescence emission from the superficial and deeper layers of tissue due to intrinsic fluorophores NADH and FAD. The fluorescence polarization spectra were collected from 21 normal and 67 oral squamous cell carcinoma biopsy tissues. The tissues were excited at 350 nm and the fluorescence emission had two peaks corresponding to NADH, and FAD respectively. The spectra were analyzed using the polarization gating technique along with the spectral deconvolution method to derive the optical redox ratio from different layers of tissue. The fractional change in redox ratio between superficial and deeper layers of tissue exhibits excellent statistical significance (p<10-3) which may be due to a shift in the metabolic pathway from oxidative phosphorylation to glycolysis in the cancer cell. Further, variation in collagen intensity in deeper layers of tissue is observed which may be attributed to the breakdown of collagen fibers in the stroma. Linear discriminant analysis showed that oral cancer tissue is discriminated with a better accuracy using polarization gating technique than that of conventional fluorescence spectroscopy.

Clinicopathological and prognostic characteristics of oral squamous cell carcinomas arising in patients with oral lichen planus: A systematic review and a comprehensive meta-analysis.

To evaluate current evidence in relation to the prognostic and clinicopathological significance of oral squamous cell carcinomas arising in patients with oral lichen planus (OLP-OSCC). We searched PubMed, Embase, Web of Science and Scopus for studies published before May-2019. We evaluated the quality of studies (QUIPS tool). We carried out meta-analyses to fulfill our objective. We examined the between-study heterogeneity and small-study effects, and conducted sensitivity and subgroup analyses. Inclusion criteria were met by 27 studies (10,505 patients with OLP, of whom 205 developed a total of 247 OSCCs). The combined 5-year mortality rate was 15.48% for OLP-OSCC (95%CI=7.34-25.19), clearly lower than the 34.70-50.00% mortality rate for conventional oral cancer communicated in previous official reports. Also, 14.67% (95%CI=6.34-24.81) of OLP-OSCC developed N+status, compared to 47.00% of conventional oral carcinomas. Likewise, most of the OSCCs in the study were T1/T2 (93.57%, 95%CI=82.20-99.88) and presented at stage I/II (81.51%, 95%CI=68.32-92.38) at the time of diagnosis, which contrasts with 50.00% of conventional carcinomas diagnosed in stages I/II. Furthermore, most of the cases were grade I (well differentiated OSCC) (67.79%; 95%CI=43.50-88.65), in comparison to conventional OSCCs, which present typically in grade II in 90.00% of cases. Our results also show an 11.21% of the OLP-OSCC patients in this study developed multiple tumors. Oral squamous cell carcinomas that developed in oral lichen planus show favorable prognostic parameters, especially with regard to the mortality rate. Around 11% of OLP-OSCC patients develop multiple tumors, which confirms that OLP can lead to field cancerization.

Association of oral dysbiosis with oral cancer development.

Oral squamous cell carcinoma (OSCC) is the leading cause of mortality for oral cancer. Numerous risk factors mainly related to unhealthy habits and responsible for chronic inflammation and infections have been recognized as predisposing factors for oral carcinogenesis. Recently, even microbiota alterations have been associated with the development of human cancers. In particular, some specific bacterial strains have been recognized and strongly associated with oral cancer development (Capnocytophaga gingivalis, Fusobacterium spp., Streptococcus spp., Peptostreptococcus spp., Porphyromonas gingivalis and Prevotella spp.). Several hypotheses have been proposed to explain how the oral microbiota could be involved in cancer pathogenesis by mainly paying attention to chronic inflammation, microbial synthesis of cancerogenic substances, and alteration of epithelial barrier integrity. Based on knowledge of the carcinogenic effects of dysbiosis, it was recently suggested that probiotics may have anti-tumoral activity. Nevertheless, few data exist with regard to probiotic effects on oral cancer. On this basis, the association between the development of oral cancer and oral dysbiosis is discussed focusing attention on the potential benefits of probiotics administration in cancer prevention.

Global and regional burdens of oral cancer from 1990 to 2017: Results from the global burden of disease study.

BackgroundData on the incidence, mortality, and other burden of oral cancer as well as their secular trends are necessary to provide policy‐makers with the information needed to allocate resources appropriately. The purpose of this study was to use the Global Burden of Disease (GBD) 2017 results to estimate the incidence, mortality, and disability‐adjusted life years (DALYs) for oral cancer from 1990 to 2017.MethodsWe collected detailed data on oral cancer from 1990 to 2017 from the GBD 2017. The global incidence, mortality, and DALYs attributable to oral cancer as well as the corresponding age‐standardized rates (ASRs) were calculated. The estimated annual percentage changes in the ASRs of incidence (ASRI) and mortality (ASRM) and age‐standardized DALYs of oral cancer were also calculated according to regions and countries to quantify the secular trends in these rates.ResultsWe tracked the incidence, mortality, and DALYs of oral cancer in 195 countries/territories over 28 years. Globally, the incidence, mortality, and DALYs of oral cancer increased by about 1.0‐fold from 1990 to 2017. The ASRI of oral cancer showed a similar trend, increasing from 4.41 to 4.84 per 100,000 person‐years during the study period. The ASRM remained approximately stable at about 2.4 per 100,000 from 1990 to 2017, as did the age‐standardized DALYs, at about 64.0 per 100,000 person‐years. ASRI was highest in Pakistan (27.03/100,000, 95% CI = 22.13‐32.75/100,000), followed by Taiwan China, and lowest in Iraq (0.96/100,000, 95% CI = 0.86‐1.06/100,000). ASRM was highest in Pakistan (16.85/100,000, 95% CI = 13.92‐20.17/100,000) and lowest in Kuwait (0.51/100,000, 95% CI = 0.45‐0.58/100,000).ConclusionsThe ASRI of oral cancer has increased slightly worldwide, while the ASRM and age‐standardized DALY have remained stable. However, these characteristics vary between countries, suggesting that current prevention strategies should be reoriented, and much more targeted and specific strategies should be established in some countries to forestall the increase in oral cancer.

Global trends in oral and pharyngeal cancer incidence and mortality.

To provide an up-to-date overview of recent trends in mortality from oral and pharyngeal cancer, we analyzed death certification data for 61 countries worldwide provided by the World Health Organization in 2010-2015, and, for selected most populous countries, over the period 1970-2016. For 12 largest countries, we analyzed incidence derived from Cancer Incidence in Five Continents in 1960-2012 for all oral and pharyngeal cancers and by subsites. In 2015, male age-standardized (world population) death rates per 100,000 were 5.03 in the European Union (EU), 8.33 in the Russian Federation, 2.53 in the United States (USA), and 3.04 in Japan; corresponding rates in women were 1.23, 1.23, 0.82, and 0.76. Male mortality decreased over the last decades in several European countries, with earlier and sharper declines in southern Europe; conversely, mortality was still increasing in a few eastern European countries and the United Kingdom. Mortality in men also decreased in Argentina, Australia, and Hong Kong, while it leveled off over more recent calendar years in Brazil, Japan, Mexico, the Republic of Korea, as well as in Australia and the USA. Female mortality slightly rose in various European countries. Overall incidence trends in the largest countries were broadly consistent with mortality ones, but oropharyngeal cancer incidence rose in many countries. Changes in tobacco and alcohol exposure in men over the last decades likely explain the favorable trends in oral and pharyngeal cancer mortality and incidence observed in selected countries worldwide, while increased human papillomavirus infection is likely responsible for the rise in oropharyngeal cancer incidence.

A spatial study of oral & pharynx cancer mortality and incidence in the U.S.A.: 2000–2015

This is a national scale study of spatial oral and pharynx cancer mortality and incidence clusters in the contiguous U.S.A. Spatial and space-time analyses of incidence and mortality rates of oral and pharynx cancers in the contiguous U.S.A. were done at the county resolution, using mortality data for the years 2000–2014 and incidence data for 2001–2015. The disease surveillance software SaTScan™ is used to identify significant cancer clusters that are non-random. In addition to a cluster analysis, regression analysis was used to adjust cancer incidence and mortality for several covariates or risk factors. This is the first study of the contiguous U.S.A. for oral and pharynx cancer in which mortality and incidence rates are studied together. The geographic clustering for mortality is somewhat different from the clustering for incidence. There exist several significant clusters in the contiguous U.S.A., both for oral and pharynx cancer incidence and for mortality. Some of the significant clusters persisted even after adjusting for several key risk factors. These clusters areas suggest a need for further investigation to identify some local concerns or needs to further address such cancer types in those specific sites. We identified statistically significant spatial and space-time clusters of oral and pharynx cancer for mortality and also for incidence in the contiguous US at the county resolution. The most important risk factors for oral cancer incidence are diabetes, alcohol drinking, and obesity, while the top risk factors for mortality are race, cervical cancer, diabetes, and alcohol drinking.

A Community-Oriented Approach to Questionnaire Development for Assessment of Oral Cancer Awareness Among Hispanic Migrant Farmworkers.

While disparities in the incidence, treatment, and mortality of oral cancer have been investigated in underrepresented groups, the Hispanic migrant farmworker population is understudied. A questionnaire was designed to assess oral cancer knowledge, awareness, and care-seeking behavior in this population. We aim to review this survey and outline its development.

Trends of mortality due to oral and oropharyngeal cancers in Uruguay from 1997 to 2014.

Background To analyze the trends of oral and oropharyngeal cancer mortality in Uruguay between 1997 and 2014 according to sex and age groups and its possible association with sociodemographic factors. Material and Methods A time-series ecological study using secondary data was performed. The data about mortality due to oral and oropharyngeal cancers were obtained from the Statistics Vitals Department of the Public Health Ministry of Uruguay. To estimate the mortality trends of the historical series, by sex, anatomical site and age groups, linear regressions generated by the Prais-Winsten procedure were used. Results The analysis of mortality trends for oral cavity and oropharyngeal cancers in Uruguay indicated that the global mortality rate was stable over the studied period. The women's mortality rate increased from 0.51 per 100,000 in 1997 to 0.65 per 100,000 in 2014 while for men, rates per 100,000 went from 3.22 in 1997 to 2.20 per 100,000 in 2014. Mortality from oral cancer in men decreased between 1997 and 2014. Mortality by oropharyngeal cancer, irrespective of sex, remained stable. Analysis by cancer site revealed decreasing trends tumors situated in the base of the tongue and gum. Years of education, unemployment, smoking and Gini index were not associated with mortality trends. Conclusions The overall mortality from oral and oropharyngeal cancer in Uruguay has remained constant in the period between 1997 and 2014. Oral cancer mortality decreased in men and increased in women and decreased at the base of the tongue. It’s necessary to continue monitoring the behavior of these diseases. Key words:Mortality, oral cancer, oropharyngeal cancer, tongue cancer.

Mortality due to oral and oropharyngeal cancer in Uruguay from 1997 to 2014.

Oral and oropharyngeal cancer is considered a public health problem in several countries due to its high incidence and mortality rate.Objective:This study aimed to analyze oral and oropharyngeal cancer mortality in Uruguay from 1997 to 2014 by age, sex and country region.Methodology:A time series ecological study using secondary data was performed. Data on mortality due to oral and oropharyngeal cancers were obtained from the Vital Statistics Department of Uruguay's Ministry of Public Health.Results:The cumulative mortality rate due to oral and oropharyngeal cancer over the study period was of 19.26/100,000 persons in women and 83.61/100.000 in men, with a mean annual rate of 1.75/100,000 in women and 7.60/100,000 in men. Mortality rate from both sites during the study period was 4.34 times higher in men than in women. Malignant neoplasms of other parts of the tongue and base of tongue showed the highest mortality rate. The means of the annual coefficients of deaths were higher for the age groups between 50 and 69 years. Higher mortality rates of oral and oropharyngeal cancer were observed in Artigas (4.63) and Cerro Largo (3.75).Conclusions:Our study described a high mortality rate for oral and oropharyngeal cancer in Uruguay from 1997 to 2014. According to the country's health department, men, tongue cancer, and oral cavity had higher mortality rates, with some variation. Prevention strategies with control of risk factors and early diagnosis are necessary to improve survival in the Uruguayan population.

Incidence and mortality of oral and oropharyngeal cancer in China, 2015.

ObjectiveTo report the incidence and mortality rates of oral and oropharyngeal cancer in Chinese population.MethodsData were taken from a population-based cancer registry collected by the National Central Cancer Registry of China (NCCRC) in 2015. The data collected from 501 local cancer registries in China were assessed using NCCRC screening methods and criteria. Incidence and mortality rates of oral and oropharyngeal cancer were stratified by age group, gender, and area. Age-standardized incidence and mortality rates were adjusted using the Chinese standard population in 2000 and Segi’s world population.ResultsIn 2015, it was estimated that there were 51,765 oral and oropharyngeal cancer incident cases and 23,830 deaths in China. The crude incidence rate of oral and oropharyngeal cancer was 3.77/100,000, and the age-standardized incidence rate by Chinese standard population and by Segi’s world standard population were 2.55/100,000 and 2.49/100,000, respectively. The crude mortality rate and the age-standardized mortality rates by Chinese standard population and by Segi’s world standard population were 1.73/100,000, 1.09/100,000 and 1.08/100,000, respectively. Both incidence and mortality rates of oral and oropharyngeal cancer were higher in males and in urban areas. Residents in eastern areas had the highest incidence and mortality rates, followed by those from middle areas and western areas. The rates of oral and oropharyngeal cancer increased greatly with age, especially after the age of 40 years.ConclusionsThis study reports the latest incidence and mortality rates of oral and oropharyngeal cancer in China. Prevention intervention including early detection, treatment, and regular follow-ups is encouraged to be set up to reduce incidence and mortality rates of oral and oropharyngeal cancer in the future.