Oral Cancer Epidemiology Reveals Distinct New Temporal and Geographic Trends

Objectives: Although downward trends have been observed in oral cancer incidence and mortality in the US, several studies have now demonstrated an increase in the incidence and mortality from oral cancers among certain groups. By examining the underlying data that comprise these trends, this study proposes to identify populations and regions that may be at greater risk for morbidity and mortality from oral cancers.

Methods: Oral cancer incidence and mortality data analyzed for this study were generated using the National Cancer Institute's Surveillance, Epidemiology and End Results program. The Behavioral Risk Factor Surveillance System, administered by the Centers for Disease Control and Prevention was then used to assess state-level risk factor data, including health conditions and risk behaviors to assess risk levels and trends in these identified populations.

Results: While oral cancer incidence and mortality rates have been declining over the past thirty years, notable increases are found among some demographic groups, including black females and white males. Detailed analysis revealed that eight states exhibited increasing rates of oral cancer deaths, particularly among older white males, contrary to the overall national trends. Although tobacco and alcohol consumption are the main risk factors for developing oral cancer, current and historical trends revealed only marginal differences in tobacco and alcohol consumption in these states from the national averages.

Conclusion: These results signify that localized geographic areas exist where the incidence and mortality from oral cancer, among particular demographic groups, have been increasing. Recent evidence for the role of other potential risk factors, including oral infection with high-risk human papillomavirus, as well as diet and nutrition, has emerged, suggesting that these areas represent sites where public health education and prevention efforts may be focused to target these specific populations in an effort to improve health outcomes and reduce disparities within these populations.