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

Abstract

Background: Data 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.

Methods: We 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.

Results: We 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).

Conclusions: The 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.

Keywords: Age-standardized rates; Disability-adjusted life years; Global Burden of Disease study; Incidence; Mortality; Oral cancer.

FIGURE 1

The percentage change in absolute number of incident cases between 1990 and 2017 and the ASRI of oral cancer in 2017 in different countries. (A) The change in incident cases of oral cancer between 1990 and 2017; (B) The ASRI of oral cancer in 2017. Countries with an extreme number of cases/evolution were annotated. ASRI, age‐standardized rate of incidence

FIGURE 2

The incidence and ASRI of oral cancer in different regions. (A) The incident cases increased in all regions from 1990 to 2017, with the most significant increase in South Asia and East Asia; (B) The ASRI has varied widely from region to region over the past 28 years; (C‐D) Changes in incident cases and ASRI over the past 28 years in five SDI regions; (E) ASRI of oral cancer in males and females in different age groups. ASRI: age‐standardized rate of incidence. SDI: socio‐demographic index

FIGURE 3

The percentage change in absolute number of deaths between 1990 and 2017 and the ASRM of oral cancer in 2017 in different countries. (A) The change in deaths of oral cancer between 1990 and 2017; (B) The ASRM of oral cancer in 2017. Countries with an extreme number of cases/evolution were annotated. ASRM, age‐standardized rate of mortality

FIGURE 4

The deaths and ASRM of oral cancer in different regions. (A) The deaths increased in all regions from 1990 to 2017, with the most significant increase in South Asia and East Asia; (B) The ASRM has varied widely from region to region over the past 28 years; (C‐D) Changes in deaths and ASRM over the past 28 years in five SDI regions; (E) ASRM of oral cancer in males and females in different age groups. ASRM: age‐standardized rate of mortality. SDI: socio‐demographic index

FIGURE 5

The percentage change in absolute number of DALYs between 1990 and 2017 and the age‐standardized DALY of oral cancer in 2017 in different countries. (A) The change in DALYs of oral cancer between 1990 and 2017; (B) The age‐standardized DALYs of oral cancer in 2017. Countries with an extreme number of cases/evolution were annotated. DALYS, disability‐adjusted life years

FIGURE 6

The DALYs and age‐standardized DALY of oral cancer in different regions. (A) The DALYs increased in all regions from 1990 to 2017, with the most significant increase in South Asia and East Asia; (B) The age‐standardized DALY has varied widely from region to region over the past 28 years; (C‐D) Changes in incident cases and age‐standardized DALY over the past 28 years in five SDI regions; (E) DALYs of oral cancer in males and females in different age groups. DALYs: disability‐adjusted life‐years. SDI: socio‐demographic index

FIGURE 7

The estimated annual percentage changes (APCs) in ASRI, ASRM, ASR‐DLAYs of oral cancer from 1990 to 2017. (A) The estimated APCs in ASRI of oral cancer; (B) The estimated APCs in ASRM of oral cancer; (C) The estimated APCs in ASR‐DALYs of oral cancer

FIGURE 8

The association between HDI (2017) and estimated APC in ASRI, ASRM, and age‐standardized DALYs of oral cancer. (A) HDI (2017) was negatively associated with estimated APC in ASRI (ρ = −0.178, P = 0.016); (B) HDI (2017) was negatively associated with estimated APC in ASRM (ρ = −0.312, P < 0.001); (C) HDI (2017) was negatively associated with estimated APC in age‐standardized DALYs (ρ = −0.319, P < 0.001). APC: annual percentage change. HDI: human development index. ASRI: age‐standardized rate of incidence. ASRM: age‐standardized rate of mortality. DALY: disability‐adjusted life‐years