Incidence Rates Of Oral Cancer Research Articles

Abstract PO-089: Racial/ethnic disparities in oral cancer screening between low-income Asian Americans aged 18-50 and their White counterparts

Abstract Background. Asian Americans (AAs) aged 18-50 have higher incidence and mortality rates of oral cancer. However, scant attention has been focusing on oral cancer disparities among this population. Although oral cancer screening is not recommended for asymptomatic adults, it's effective in oral cancer early detection among high-risk populations. The study aimed at assessing the racial/ethnic disparities in oral cancer screening experienced by Asian Americans aged 18-50 living federal poverty level, comparing with their White counterparts. Method. The sample consists of 1540 low-income adults (478 AAs and 1062 Whites) aged 18-50 from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) combined datasets. Weighting was applied since NHANES oversampled Asian Americans. We conducted bivariate analysis such as t-test and chi-square test to examine the association between demographic and behavioral factors =and oral cancer screening among high-risk populations. Multiple logistic regressions were used to identify the risk factors of oral cancer screening disparities. All data analyses were conducted in Stata 16. A p value smaller than 0.05 was considered statistically significant, while a p value between 0.05-0.1 was taken as marginally significant criteria. Results. AAs are predominately foreign-born (79.13%), about half of them only spoke their native languages at home (47.69%), and 27.31% of them did not have health insurance. Overall, AAs had significantly lower oral cancer screening rate than Whites (7.33% vs. 16.69%, p=0.006). Specifically, within those who were not covered with health insurance, AAs were less likely to receive oral cancer screening than Whites (3.5% vs.13.73%, p=0.060); among those who did not receive any HPV vaccine shots, Asians had lower oral cancer screening rate than Whites (7.64% vs.14.72%, p=0.058); among those who were not self-motivated to visit their dentists, Asians reported extremely low oral cancer screening rate (2.24%), which was significantly (p=0.016) lower than that of Whites (10.27%). Although Asians had higher self-motivation to do dental visit than Whites (62.96% vs. 52.72%, p=0.009), among self-motivated patients, AAs were less likely to be told the importance of checking for oral cancer by their dentists (12.94% vs. 23.54%, p=0.063), compared with Whites. Logistic regressions also showed that the negative impacts of less-frequent dental visits on oral cancer screening was stronger among AAs (OR=0.45, p=0.042) than in Whites (OR=0.75, p=0.005), controlling for other variables. Conclusion. AAs experience oral cancer screening disparities among multiple high-risk/vulnerable populations. There is an urgent need of educational intervention to promote oral cancer screening for AAs, especially among high-risk subpopulations, and to improve dentists' awareness of AAs' oral cancer screening needs. Citation Format: Wenyue Lu, Lin Zhu, Bohui Wang, Di Zhu, Ming-chin Yeh, Grace X. Ma. Racial/ethnic disparities in oral cancer screening between low-income Asian Americans aged 18-50 and their White counterparts [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-089.

HISTOPATHOLOGICAL IMAGE ANALYSIS FOR ORAL CANCER CLASSIFICATION BY SUPPORT VECTOR MACHINE

Oral cancer is caused by the mutation of the cells in the lips or in the mouth. The incidence rate and prevalence rate of oral cancer are increasing worldwide. Recently, the Machine Learning (ML) approaches play a vital role in medical image diagnosis. They provide accurate and rapid evaluation of the analysis of histopathological images using supervised learning. In this study, three different modules are developed namely preprocessing, feature extraction and classification module. Initially, the raw histopathological image is given to the median filter for the removal of background noise in the preprocessing module. In the next module, the temporal features such as energy, entropy etc., are extracted from the color components of the filtered images. Finally, the classification is done by employing the Support Vector Machine (SVM) and K-Nearest Neighbour (KNN) to classify histopathological images as normal or abnormal. Results show that the SVM classifier is better than KNN for the classification of oral cancer. The classification accuracy on 1224 histopathological images has been improved to 98% by using SVM classifier as compared with the KNN results of 83%.

Diverging incidence trends of oral tongue cancer compared to other head and neck cancers in young adults in France.

While head and neck cancer incidence decreased worldwide due to reduced tobacco and alcohol consumption, oral tongue cancer (OTC) incidence has been reported to be increasing in several countries. Our study examines the incidence trends of OTC in France from 1990 to 2018, globally and by age; and compares the incidence trends with the evolution of the incidence of other human papilloma virus-unrelated head and neck squamous cell carcinoma, that is, cancers of the remaining subsites of the oral cavity (RSOCC) and laryngeal cancers for the period 1990 to 2018. World age-standardized incidence rates of oral tongue cancers (C02), cancers of the remaining subsites of the oral cavity (RSOCC, C03-06) and laryngeal cancers (C32) were estimated using the French National Network of Cancer Registries for the period 1990 to 2018. Trends in national incidence rates were estimated from a mixed-effect Poisson model including age and year effects using penalized splines and a district-random effect. In women aged 30 and 40, a significant increase in OTC incidence was observed, while ROSCC showed a nonsignificant incidence decrease. In young men aged 25, a marginally significant increase of OTC incidence years was observed, while incidence rates of RSOCC significantly declined. The results suggest a tendency towards diverging incidence trends for OTC compared to RSOCC and laryngeal cancer in young adults. The observed trends may reflect changes in underlying exposures or emerging exposures not yet identified, and stress the need to further investigate the etiology of oral tongue cancers.

Factors to consider for surgical in elderly patients with oral cancer

At present, in Korea, due to developments in medicine and technology and an increasing mean lifespan, the expected lifetime for elderly people is increasing (at 70 years, the expected additional lifespan is 14.8 years for males and 18.3 years for females). However, among all causes of death, malignant neoplasm is ranked first for all ages. Further, the incidence rate of oral cancer tends to increase with age. Thus, oral and maxillofacial surgeons have increased opportunity to experience the ‘oldest old’ patients with oral cancer. Elderly patients commonly have several comorbidities, poor general condition, limited socioeconomic support, fear of various postoperative complications, and perception of short for the rest of their life. In this situation, the patient, caregiver, and surgeon often choose undergraded treatment rather than standard treatment for oral squamous cell carcinoma owing to patient age. In elderly patients with oral cancer, ablation of tumor or reconstructive surgery is challenging for surgeons. Oral and maxillofacial surgeons must evaluate carefully the patient’s medical condition and make a decision regarding treatment plans after sufficient discussion with patient and caregivers. We review the literature to consider the factors involved for deciding on a treatment plan regarding surgery in elderly patients with oral cancer.

1375Age-standardization to world population and under-estimation of oral cancer burden

Abstract Background Age-standardization is common for adjustment of unequal population in different ages as it can influence cancer incidence. However, for planning healthcare services (including screening), one needs absolute magnitude since everyone needs intervention. This study assessed the effect of age-standardization on understanding the global differentials in magnitude of oral cancer. Methods Data on cancer incidence rates of oral cancers for 2008-2012, was obtained from the website of international agency for research on cancer for all 334 population-based cancer registries. Scatter plots were prepared between age-standardized and crude incidence rates to assess the ratio between them according to proportion of old people for all countries. Areas with high occurrence of oral cancer were identified. Results The ratio between age-standardized and crude incidence rate was >1 in countries with high proportion of older population (high-development-index countries), indicating an artificial widening of gap between incidence rates between countries due to age-standardization. Six areas had higher crude incidence rate among men than India. Based on the published estimates, the per-unit-population burden in Europe was 6.3% higher than India, while in USA it was merely 12.5% lower than India. Conclusions The perception of low burden of oral cancer in high-economy countries is artificial, brought about by common practice of age-standardization. Key messages Organization of oral cancer screening activities by countries with resources and expertise will provide much needed knowledge on its natural history and efficacy of control strategies.

Surveillance of the Incidence and Mortality of Oral and Pharyngeal, Esophageal, and Lung Cancer in Nevada: Potential Implications of the Nevada Indoor Clean Air Act.

Reviews of national and state-specific cancer registries have revealed differences in rates of oral, esophageal, and lung cancer incidence and mortality that have implications for public health research and policy. Many significant associations between these types of cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans—including the Nevada Clean Indoor Air Act (NCIAA) of 2006 (and subsequent modification in 2011). Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of oral and pharyngeal, esophageal, and lung cancer incidence and mortality in Nevada. Methods: Cancer incidence and mortality rate data were obtained from the National Cancer Institute (NCI) Division of Cancer Control and Population Sciences (DCCPS) Surveillance, Epidemiology and End Results (SEER) program. Most recently available rate changes in cancer incidence and mortality for Nevada included the years 2012–2016 and are age-adjusted to the year 2000 standard US population. This analysis revealed that the overall rates of incidence and mortality from these types of cancer in Nevada differs from that observed in the overall US population. For example, although the incidence rate of oral cancer is decreasing in the US overall (0.9%), it is stable in Nevada (0.0%). However, the incidence and mortality rates from esophageal cancer are also decreasing in the US (−1.1%, −1.2%, respectively), and are declining more rapidly in Nevada (−1.5%, −1.9%, respectively). Similarly, the incidence and mortality rates from lung are cancer are declining in the US (−2.5%, −2.4%, respectively) and are also declining more rapidly in Nevada (−3.2%, −3.1%, respectively). Analysis of previous epidemiologic data from Nevada (1999–2003) revealed the highest annual percent change (APC) in oral cancer incidence in the US was observed in Nevada (+4.6%), which corresponded with the highest APC in oral cancer mortality (+4.6%). Subsequent studies regarding reduced rates of cigarette use due to smoking restrictions and bans have suggested that follow up studies may reveal changes in the incidence and mortality rates of oral and other related cancers. This study analysis revealed that oral cancer incidence rates are no longer increasing in Nevada and that mortality rates have started to decline, although not as rapidly as the overall national rates. However, rapid decreases in both the incidence and mortality from esophageal and lung cancer were observed in Nevada, which strongly suggest the corresponding changes in oral cancer may be part of a larger epidemiologic shift resulting from improved public health policies that include indoor smoking restrictions and bans.

Favorable Lip and Oral Cancer Mortality-to-Incidence Ratios in Countries with High Human Development Index and Expenditures on Health.

Background: The incidence rates of lip and oral cancer have continued to increase, and prognosis is associated with a country’s socioeconomic status. The mortality-to-incidence ratio (MIR) is a reasonable indicator of disparities in cancer screening and treatment. In this study, we aimed to understand the association between economic status and cancer prognosis. Methods: Data were obtained from the Global Cancer Observatory (GLOBOCAN) and the World Health Organization (WHO). The MIRs were compared to evaluate the correlation with the human development index (HDI), the current health expenditure (CHE), and the ratio of CHE over gross domestic product (CHE/GDP) disparities via Spearman’s rank correlation coefficient. Results: The results showed that Asia had the most cases and deaths. In addition, they showed a significant association (p < 0.001, p = 0.005, and p < 0.001, respectively) of the crude rate (CR) of incidence with the HDI, the CHE, and the CHE/GDP. However, their associations with mortality rate (p = 0.303, p = 0.997, and p = 0.101) were not significant. Regarding the correlation of the MIRs, the results revealed a significant association with the HDI, the CHE, and the CHE/GDP (p < 0.001, p < 0.001, and p < 0.001, respectively). Conclusion: Countries with higher HDI, CHE per capita, and CHE/GDP tend to have lower MIRs, which indicates favorable clinical outcomes.

Incidence rates of oral cavity and oropharyngeal cancers among men: a comparison of active-duty military and general populations.

This study compared oral cavity and oropharyngeal cancer incidence rates and trends among men in the active-duty military and the general population of the USA. Data were from the Department of Defenses' Automated Central Tumor Registry (ACTUR) and the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER-9) registries. Age-adjusted oral cavity and oropharyngeal cancer incidence rates among men aged 20-59 from 1990-2013 were compared between ACTUR and SEER populations. The age-adjusted oral cancer incidence rate was lower in ACTUR than SEER (IRR = 0.89, 95% confidence interval (CI), 0.81-0.98). Incidence was lower in ACTUR for oral cavity cancer (IRR = 0.75, 95% CI, 0.66-0.89) and remained lower when stratified by age and race. ACTUR oropharyngeal cancer rates were higher than SEER among Whites (IRR = 1.19, 95% CI, 1.01-1.39) and men aged 40-59 (IRR = 1.18, 95% CI, 1.00-1.39). Oropharyngeal cancer increased for both populations over time, whereas oral cavity cancer increased in ACTUR but decreased in SEER. Rates were lower in ACTUR than SEER for oral cavity, but not for oropharyngeal cancer. Temporal oral cancer incidence patterns differed between the two populations. This study provides clues for more research on possible variations between these two populations and related factors.

Racial Disparity Among Adults With Oral Cancer Persists in the U.S. from 2000 to 2017

Background: We investigated trends in incidence rates, stage at diagnosis and relative survival rates among adults with oral cancer in relation to race in the context of previously uncovered cancer-specific health disparities.Methods: We analyzed 2000—2017 SEER data among adults with oral cancer from 18 registries. We used SEER*Stat to compute proportions for each oral cancer site by stage at diagnosis and race and five-year relative survival rates by sex, cancer site, stage at diagnosis, age and race and explored trends over time.Results: Among 95,040 oral cancer cases reported to SEER, the most prevalent site was the tongue. While the rate among Black men decreased from 12.9 to 8/100,000, Blacks had significantly higher proportions of oral cancer that had spread at diagnosis than whites. Survival rates were substantially lower among Blacks than whites.Conclusions: The steep decline in oral cancer incidence rates in Black men is encouraging, although the persistent racial disparity with respect to late diagnosis and poor survival is alarming, requiring targeted interventions.Practical implications: Highlighting racial disparities with respect to oral cancer to increase awareness is the first step in developing interventions to address these disparities.

The burden of oral cancer in China, 1990\u20132017: an analysis for the Global Burden of Disease, Injuries, and Risk Factors Study 2017

BackgroundOral cancer is among the most common malignant tumors worldwide, and it has become an increasingly important public health problem in China. This study systematically assesses the current state of oral cancer in China from 1990 to 2017, providing new information and perspectives for oral health researchers and public health policy makers.MethodsBased on the Global Burden of Disease, Injuries, and Risk Factors Study 2017 (GBD 2017), we evaluated the incidence rates, mortality and disability-adjusted life year (DALY) rates for oral cancer in China and their changing trends between 1990 and 2017, making comparisons by gender and age. We also assessed the DALY rates associated with oral cancer at the provincial level for 33 provinces and their trends over time.ResultsFrom 1990 to 2017, the number of new cases and the age-standardized incidence rate for oral cancer in China increased by 280.0% and 79.7%, respectively; the number of deaths and the age-standardized mortality rose by 196.8% and 29.0%, respectively; and the number of DALYs and the age-standardized DALY rate increased by 149.1% and 21.0%, respectively. The incidence rates for oral cancer rose after 30 years of age and peaked at 65–69 years; the mortality for oral cancer rose after 50 years of age and peaked at 65–69 years; and the DALY rates for oral cancer rose after 45 years of age and peaked at 65–69 years. The incidence rates, mortality and DALY rates for oral cancer in males were significantly higher than those in females and showed an upward trend, while there was a decrease or no significant change in females. The DALY rates increased in 21 provinces and decreased in 12 provinces, with the largest growth in Henan Province and the largest decline in Hong Kong Province.ConclusionsThe burden of oral cancer in China continues to increase continuously. More prevention, control and intervention measures should be taken and increased attention paid to common risk factors is essential for the prevention of oral cancer.

Area-level deprivation and oral cancer in England 2012–2016

BackgroundThe relationship between deprivation and oral cancer is complex. We examined magnitude and shape of deprivation-related inequalities in oral cancer in England 2012-2016. MethodsOral cancer was indicated by cancers of the lip and oral cavity (ICD10 C00-C06) and lip, oral cavity and pharynx (C00-C14) and deprivation by the Index of Multiple Deprivation. Deprivation inequality in incidence and mortality rates of oral cancer outcomes was measured using the Relative Index of Inequality (RII). Fractional polynomial regression was used to explore the shape of the relationships between deprivation and oral cancer outcomes. Multivariate regression models were fitted with the appropriate functions to examine the independent effect of deprivation on cancer adjusting for smoking, alcohol and ethnicity. ResultsIncidence rate ratios (IRRs) and mortality rate ratios (MRRs) were greater for more deprived areas. The RII values indicated significant inequalities for oral cancer outcomes but the magnitude of inequalities were greater for mortality. The relationships between deprivation and oral cancer outcomes were curvilinear. Deprivation, Asian ethnicity and alcohol consumption were associated with higher incidence and mortality rates of oral cancer. ConclusionThis is the first study, to our knowledge, exploring the shape of socioeconomic inequalities in oral cancer at neighbourhood level. Deprivation-related inequalities were present for all oral cancer outcomes with a steeper rise at the more deprived end of the deprivation spectrum. Deprivation predicted oral cancer even after accounting for other risk factors.

Suppression of oral cancer by induction of cell cycle arrest and apoptosis using Juniperus communis extract.

The oral cancer incidence rate is slowly increasing and is now the fifth leading cause of cancer-related death due to its high metastasis and recurrence rate. Juniperus communis is used as a traditional Chinese medicine and has been proven to have anti-cancer activity against neuroblastomas. In the present study, we further investigated the anti-cancer mechanisms of J. communis extract (JCo) on oral cancer and evaluated the synergistic effects of JCo combined with 5-fluorouracil (5-FU). We found that JCo inhibited oral cancer cell growth, and that JCo might be less cytotoxic to normal cells than to cancer cells. After JCo treatment, cell cycle arrest was observed at the G0/G1 phase through modulation of p53/p21 and Rb signaling. JCo also caused an increase in the sub-G1 phase and cell apoptosis via the intrinsic and extrinsic apoptosis pathways. JCo combined with 5-FU presented a synergistic effect to reduce cell viability. In conclusion, JCo inhibited oral cancer cell growth by inducing cell cycle arrest and activating cell apoptosis, and JCo significantly synergized with 5-FU. JCo might have the potential to be an adjuvant and a new therapeutic drug for oral cancer treatment.

Oral cancer incidence rates from 1997 to 2016 among men in Taiwan: Association between birth cohort trends and betel nut consumption.

Oral cancer is the fourth most common cancer among men in Taiwan. Betel nut consumption is a major risk factor for oral cancer, but the association between betel nut chewing and the long-term secular trend of oral cancer incidence is unclear. We conducted an age-period-cohort analysis to examine the incidence rates of oral cancer among men in Taiwan from 1997 to 2016. The oral cancer incidence rate among men doubled between 1997 and 2009, but the trend leveled off thereafter. Oral cancer incidence rates in the oldest age group (80-84y) were approximately 85 times those of the youngest group (25-29y). The period effect was weak, and the cohort effect exhibited a drastically increasing trend from 1917 (midyear for 1913-1921) to 1972 (1968-1976) birth cohorts and then a decreasing trend afterward. The Spearman rank correlation coefficient between the cohort effects on oral cancer incidence among men and the average consumption of betel nut with a lag time of 30years had a significant and extremely high value of 0.993. Our findings suggest that betel nut chewing is the main driver of the cohort effect for oral cancer incidence rates among men in Taiwan. In addition to reduced betel nut consumption, a decrease in smoking prevalence may also have contributed to the reduction in oral cancer incidence after the 1972 birth cohort; moreover, the increasing prevalence of alcohol consumption in Taiwan is unlikely to be the reason for the cohort effect for oral cancer.

Oral cavity cancer incidence rates in Osaka, Japan between 2000 and 2014.

We investigated trends in oral cavity cancer incidence from 2000 to 2014 in Osaka, Japan. Using Osaka Cancer Registry (OCR) data, oral cavity cancer incidence number and age-standardized incidence rates were calculated according to three 5-year-time-periods: 2000-2004, 2005-2009 and 2010-2014. We calculated the distribution of clinical stage for each 5-year period and the proportion of oral cavity cancer among all cancers. A total of 6,086 oral cavity cancers were registered in OCR in 2000-2014. Across the period, between 55.6% and 65.0% were 65years+and approximately 60% were men. Tongue cancer accounted for 30.4% to 43.8% of the registrations, while gum accounted for 30.7% to 34.7%. 36.3% to 37.3% were regional, while 1.8% to 2.8% were distant. The age-standardized incidence rate of oral cavity cancer increased from 2.1/100,000 in 2000 to 3.8/100,000 in 2014, although the proportion of oral cavity cancer among all cancers only increased slightly from 0.71% in 2000 to 0.92% in 2014. Proportion of localized stage cancer was 60.8%-67.5% for tongue and 31.0%-49.5% for gum or floor of mouth. Proportion of distant stage cancer was 0.3%-1.0% for tongue and 2.5%-4.2% for gum or floor of mouth. Age-standardized incidence rate of oral cavity cancer increased, but was not higher than other countries. The proportion of localized stage tongue cancer was higher, while that of distant stage cancer was lower than other sites. Tongue cancer might be easier to detect in its earlier stages than other sites.

Global patterns and trends in cancers of the lip, tongue and mouth.

Global descriptions of international patterns and trends in oral cancer are informative in providing insight into the shifting epidemiologic patterns and the potential prevention of these tumours. We present global statistics on these cancers using the comprehensive set of national estimates and recorded data collated at the International Agency for Research on Cancer (IARC). The estimated number of lip and oral cavity cases and deaths in the 185 countries for the year 2018 was extracted from IARC's GLOBOCAN database of national estimates. To examine trends, recorded data series on lip and oral cavity cancers, as well as corresponding population-at-risk data were extracted from successive volumes of Cancer Incidence in Five Continents. Globally, the highest incidence was found in South-Central Asia and parts of Oceania, with the highest estimated incidence rates in Papua New Guinea, Pakistan and India. The highest observed rates of lip cancer were in Australia, while India had the highest incidence rates of mouth and oral tongue cancer. Trends are diverse, with lip cancer incidence rates continuing to decrease for both sexes; the incidence rates of mouth cancer are also in decline in males, although increasing rates among females were observed in some populations. There are some grounds for optimism given the prospects for control of these cancers. Primary prevention should however focus on the reduction of the main causes, namely, tobacco and alcohol consumption.

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.

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.

Relationship between the Human Development Index and its Components with Oral Cancer in Latin America

To evaluate the relationship between the Human Development Index (HDI) and its components with oral cancer (OC) in Latin America. Ecological study in 20 Latin American countries in 2010 and 2017, which evaluated the relationship between the Age-Standardized Rates (ASRs) of incidence and mortality from oral cancer and the following indicators: HDI, with its components (income, education, and health indexes); and the Gini and Theil-L indexes. Among the countries with the highest HDI, men from Brazil and Cuba had the highest incidence and mortality ASRs per 100,000 inhabitants (ASR incidence >7.5 and mortality >4.5). Among those with the lowest HDI, Haiti was the most affected country (ASR incidence >4.1 and mortality >3.0). The highest male:female ratio was in Paraguay in both years (incidence >3.5 and mortality >4.0). Mortality from oral cancer is negatively related to the global HDI in both years, with regression coefficients (95% confidence interval) being −5.78 (−11.77, 0.20) in 2010 and −5.97 (−11.38, −0.56) in 2017; and separate (independent) from the income [−4.57 (−9.92, 0.77) in 2010 and −4.84 (−9.52, −0.17) in 2017] and health indexes [−5.81 (−11.10, −0.52) and −6.52 (−11.32, −1.72) in 2017] (p < 0.05) in the countries with lower HDI. Oral cancer incidence and mortality rates vary both among and within Latin American countries according to sex, with a greater burden on men. The HDI is negatively related to mortality from oral cancer in the countries of medium and low HDI.

Dissection of posterior triangle and lower deep jugular lymph node is mandatory in therapeutic neck dissection as a part of treatment for squamous cell carcinoma of oral cavity with clinically N1 neck

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; In India oral cancer is the commonest malignant neoplasm, accounting for 20-30% of all cancers. Southern India presents the highest oral cancer incidence rates among women worldwide.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was conducted in R. L. Jalappa Hospital and Research Centre and SDU Medical College Kolar, Karnataka. Thirty patients having oral squamous cell carcinoma with clinically N&lt;sub&gt;1 &lt;/sub&gt;neck undergoing modified radical neck dissection between December 2010 and June 2012 were enrolled in the study. The objective of study was to determine whether dissection of posterior triangle and lower deep jugular lymph node is mandatory in therapeutic neck dissection as a part of treatment for squamous cell carcinoma of oral cavity with clinically N&lt;sub&gt;1 &lt;/sub&gt;neck. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of 24 patients, 16 patients underwent wide excision with hemimandibulectomy. In these 16 cases, 2 patients had reconstruction with double flap while rest 14 cases with island pectoralis major myocutaneous flap. Out of remaining 8 patients, 2 patients underwent marginal mandibulectomy. In all these 8 patients, reconstruction was done using nasolabial flap in 1 patient, buccal pad of fat in 2 patients, masseter flap in 1 patient and forehead flap in 4 patients. In carcinoma anterior 2/3&lt;sup&gt;rd&lt;/sup&gt; tongue, all 6 patients underwent hemiglossectomy with simultaneous modified radical neck dissection.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; It was concluded that during neck dissection, it may be oncologically safe to avoid level IV and level V clearance in buccal mucosa squamous cell carcinoma with N&lt;sub&gt;1&lt;/sub&gt; neck.&lt;/p&gt;

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

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.