Tobacco and alcohol use are the risk factors responsible for the greatest burden of head and neck cancers: a study from the Global Burden of Disease Study 2019

Abstract

Background: The risk factors associated with cancers of the larynx, nasopharynx, lips, and oral cavity, as well as other pharyngeal cancers, share many similarities. To better understand how these risk factors manifest differently across various head and neck tumor types, we utilized data from the GBD database to conduct an in-depth analysis.

Methods: Our study employed the 2019 GBD dataset to scrutinize trends in incidence, mortality, and DALYs related to these cancers. This analysis covered the period from 1990 to 2019 and was stratified by sex, age, geographical region, and the socio-demographic index.

Findings: In 2019, lip and oral cavity cancers were found to have the highest incidence rates, with notably higher ASIRs observed in males compared to females. Interestingly, the ASIRs for laryngeal cancer showed a decreasing trend over the studied time frame from 1990 to 2019. Our findings revealed that smoking posed a significantly greater risk for laryngeal and lip and oral cavity cancers, whereas alcohol consumption was more strongly linked to NPC. Central Europe exhibited the ASDR for laryngeal cancer. For lip and oral cavity cancer, the impact of tobacco chewing on female ASDR was most pronounced in South Asia. In contrast, nasopharyngeal cancer had its highest ASDR in Asia.

Conclusion: Our investigation underscores that smoking and alcohol consumption are leading risk factors for cancers of the head and neck, although their effects vary depending on the specific type of cancer, the sex of the patient, age group, and regional demographics. While occupational exposure to carcinogenic substances does not appear to be a predominant factor, it remains an important consideration that should not be overlooked in the comprehensive assessment of risk for these malignancies.

Keywords: Global burden of disease; alcohol use; head and neck cancer; risk factors; smoking.

Figure 1.

Age-standardized death rate (ASDR) and age-standardized DALY rate of head and neck cancer by risk factors worldwide from1990 to 2019. (A) larynx cancer; (B) lip and oral cavity cancer; (C) nasopharynx cancer; (D) other phraynx cancer.

Figure 2.

Age-standardized incidence rate(ASIR) of head and neck cancer in men and women worldwide from 1990 to 2019.

Figure 3.

Absolute rate of death from head and neck cancer by age in men and women in 2019 and with age-standardised rate.ASDR:age-standardized death rate(per 100000).

Figure 4.

Absolute rate of DALY(per 100000) from head and neck cancer by age in men and women in 2019 and with age-standardised rate.

Figure 5.

Age-standardized death rate(ASDR) of head and neck cancer by smoking and alcohol use in 21 GBD regions and 5 SDI regions in 2019. (A) Distribution of the effects of smoking on ASDR in head and neck cancer in 5 SDI regions; (B) Distribution of the effects of alcohol use on ASDR in head and neck cancer in 5 SDI regions; (C) Distribution of the effects of smoking on ASDR in head and neck cancer in 21 GBD regions; (D) Distribution of the effects of alcohol use on ASDR in head and neck cancer in 21 GBD regions;

Figure 6.

Age-standardized DALY rate of head and neck cancer by smoking and alcohol use in different 21 GBD regions and 5 SDI regions in 2019. (A) Distribution of the effects of smoking on age-standardized DALY rate in head and neck cancer in 5 SDI regions; (B) Distribution of the effects of alcohol use on age-standardized DALY rate in head and neck cancer in 5 SDI regions; (C) Distribution of the effects of smoking on age-standardized DALY rate in head and neck cancer in 21 GBD regions; (D) Distribution of the effects of alcohol use on age-standardized DALY rate in head and neck cancer in 21 GBD regions.