e18053 Background: Despite the relatively rare incidence of tongue cancer in the United States, 2,830 people were estimated to have died from it in 2020. Research has indicated disparities in oral cancer screenings among minority and low-income patients. The aim of the present study is to characterize the incidence of tongue cancer across in the US population and to determine mediators of survival months. Methods: SEER 18 regions database (November 2019 submission) was queried to obtain data on tongue cancer incidence, patient demographics, and clinical variables for patients (n=51,622) from 2000-2017 using SEER*Stat 8.3.8. Data analysis were performed using R and RStudio version 4.02, and 1.3.1073, respectively. For comparison between groups, Chi-squared test for independence, Fisher’s exact test, and Wilcoxon signed-rank test were applied where applicable. Univariate and multivariate regression models characterized the relationship between survival months and sex, race, primary site, and additional patient characteristics. Results: Several significant group differences were determined in the incidence of tongue cancer. Patient sex was significantly associated (P<0.001), with survival months in White patients, with median survival months 33 (IQR 11,85) and 35 (IQR 12,82) for females and males respectively. Regression analysis found multiple patient level characteristics significantly mediating survival months. The odds ratio (OR) for reported patient race of Black were OR 0.78 (95% CI 0.68, 0.89; P<.001) and OR 0.75 (95% CI 0.66, 0.86; P<.001) for univariate and multivariate regression, respectively. Conclusions: The study indicates that health disparities vis-à-vis social determinants of health play a role in mediating differences in tongue cancer survival months for patients in the US. Further research should characterize and address persisting health inequities and potential solutions in oral cancer incidence and mortality.[Table: see text]