The Global, Regional, and National Burden of Adult Lip, Oral, and Pharyngeal Cancer in 204 Countries and Territories: A Systematic Analysis for the Global Burden of Disease Study 2019

Amanda Ramos da Cunha*, Kelly Compton, Rixing Xu, Rashmi Mishra, Mark Thomas Drangsholt, Jose Leopoldo Ferreira Antunes, Alexander R Kerr, Alistair R Acheson, Dan Lu, Lindsey E Wallace, Jonathan M Kocarnik, Weijia Fu, Frances E Dean, Alyssa Pennini, Hannah Jacqueline Henrikson, Tahiya Alam, Emad Ababneh, Sherief Abd-Elsalam, Meriem Abdoun, Hassan AbidiHiwa Abubaker Ali, Eman Abu-Gharbieh, Tigist Demssew Adane, Isaac Yeboah Addo, Aqeel Ahmad, Sajjad Ahmad, Tarik Ahmed Rashid, Maxwell Akonde, Hanadi Al Hamad, Fares Alahdab, Yousef Alimohamadi, Vahid Alipour, Sadeq Ali Al-Maweri, Ubai Alsharif, Alireza Ansari-Moghaddam, Sumadi Lukman Anwar, Anayochukwu Edward Anyasodor, Jalal Arabloo, Aleksandr Y Aravkin, Raphael Taiwo Aruleba, Malke Asaad, Tahira Ashraf, Seyyed Shamsadin Athari, Sameh Attia, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Muhammad Badar, Nayereh Baghcheghi, Maciej Banach, Mostafa Dianatinasab, GBD 2019 Lip, Oral, and Pharyngeal Cancer Collaborators

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

IMPORTANCE: Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning. OBJECTIVE: To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates. EVIDENCE REVIEW: The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019. FINDINGS: In 2019, 370?000 (95% uncertainty interval [UI], 338?000-401?000) cases and 199?000 (95% UI, 181?000-217?000) deaths for LOC and 167?000 (95% UI, 153?000-180?000) cases and 114?000 (95% UI, 103?000-126?000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia. CONCLUSIONS AND RELEVANCE: In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts.
Original languageEnglish
Pages (from-to)1401-1416
Number of pages16
JournalJAMA Oncology
Volume9
Issue number10
Early online dateSept 2023
DOIs
Publication statusPublished - 19 Oct 2023

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