The Global, Regional, and National Burden of Adult Lip, Oral, and Pharyngeal Cancer in 204 Countries and Territories
Authors:   GBD 2019 Lip, Oral, and Pharyngeal Cancer Collaborators, Cunha Amanda Ramos da , Compton Kelly , Xu Rixing , Mishra Rashmi , Drangsholt Mark Thomas , Antunes Jose Leopoldo Ferreira , Kerr Alexander R. , Acheson Alistair R. , Lu Dan , Wallace Lindsey E. , Kocarnik Jonathan M. , Fu Weijia , Dean Frances E. , Pennini Alyssa , Henrikson Hannah Jacqueline , Alam Tahiya , Ababneh Emad , Abd-Elsalam Sherief , Abdoun Meriem , Abidi Hassan , Abubaker Ali Hiwa , Abu-Gharbieh Eman , Adane Tigist Demssew , Addo Isaac Yeboah , Ahmad Aqeel , Ahmad Sajjad , Ahmed Rashid Tarik , Akonde Maxwell , Al Hamad Hanadi , Alahdab Fares , Alimohamadi Yousef , Alipour Vahid , Al-Maweri Sadeq Ali , Alsharif Ubai , Ansari-Moghaddam Alireza , Anwar Sumadi Lukman , Anyasodor Anayochukwu Edward , Arabloo Jalal , Aravkin Aleksandr Y. , Aruleba Raphael Taiwo , Asaad Malke , Ashraf Tahira , Athari Seyyed Shamsadin , Attia Sameh , Azadnajafabad Sina , Azangou-Khyavy Mohammadreza , Badar Muhammad , Baghcheghi Nayereh , Banach Maciej , Bardhan Mainak , Barqawi Hiba Jawdat , Bashir Nasir Z. , Bashiri Azadeh , Benzian Habib , Bernabe Eduardo , Bhagat Devidas S. , Bhojaraja Vijayalakshmi S. , Bjørge Tone , Bouaoud Souad , Braithwaite Dejana , Briko Nikolay Ivanovich , Calina Daniela , Carreras Giulia , Chakraborty Promit Ananyo , Chattu Vijay Kumar , Chaurasia Akhilanand , Chen Meng Xuan , Cho William C. S. , Chu Dinh-Toi , Chukwu Isaac Sunday , Chung Eunice , Cruz-Martins Natália , Dadras Omid , Dai Xiaochen , Dandona Lalit , Dandona Rakhi , Daneshpajouhnejad Parnaz , Darvishi Cheshmeh Soltani Reza , Darwesh Aso Mohammad , Debela Sisay Abebe , Derbew Molla Meseret , Dessalegn Fikadu Nugusu , Dianati-Nasab Mostafa , Digesa Lankamo Ena , Dixit Shilpi Gupta , Dixit Abhinav , Djalalinia Shirin , El Sayed Iman , El Tantawi Maha , Enyew Daniel Berhanie , Erku Daniel Asfaw , Ezzeddini Rana , Fagbamigbe Adeniyi Francis , Falzone Luca , Fetensa Getahun , Fukumoto Takeshi , Gaewkhiew Piyada , Gallus Silvano , Gebrehiwot Mesfin , Ghashghaee Ahmad , Gill Paramjit Singh , Golechha Mahaveer , Goleij Pouya , Gomez Ricardo Santiago , Gorini Giuseppe , Guimaraes Andre Luiz Sena , Gupta Bhawna , Gupta Sapna , Gupta Veer Bala , Gupta Vivek Kumar , Haj-Mirzaian Arvin , Halboub Esam S. , Halwani Rabih , Hanif Asif , Hariyani Ninuk , Harorani Mehdi , Hasani Hamidreza , Hassan Abbas M. , Hassanipour Soheil , Hassen Mohammed Bheser , Hay Simon I. , Hayat Khezar , Herrera-Serna Brenda Yuliana , Holla Ramesh , Horita Nobuyuki , Hosseinzadeh Mehdi , Hussain Salman , Ilesanmi Olayinka Stephen , Ilic Irena M. , Ilic Milena D. , Isola Gaetano , Jaiswal Abhishek , Jani Chinmay T. , Javaheri Tahereh , Jayarajah Umesh , Jayaram Shubha , Joseph Nitin , Kadashetti Vidya , Kandaswamy Eswar , Karanth Shama D. , Karaye Ibraheem M. , Kauppila Joonas H. , Kaur Harkiran , Keykhaei Mohammad , Khader Yousef Saleh , Khajuria Himanshu , Khanali Javad , Khatib Mahalaqua Nazli , Khayat Kashani Hamid Reza , Khazeei Tabari Mohammad Amin , Kim Min Seo , Kompani Farzad , Koohestani Hamid Reza , Kumar G. Anil , Kurmi Om P. , La Vecchia Carlo , Lal Dharmesh Kumar , Landires Iván , Lasrado Savita , Ledda Caterina , Lee Yo Han , Libra Massimo , Lim Stephen S. , Listl Stefan , Lopukhov Platon D. , Mafi Ahmad R. , Mahumud Rashidul Alam , Malik Ahmad Azam , Mathur Manu Raj , Maulud Sazan Qadir , Meena Jitendra Kumar , Mehrabi Nasab Entezar , Mestrovic Tomislav , Mirfakhraie Reza , Misganaw Awoke , Misra Sanjeev , Mithra Prasanna , Mohammad Yousef , Mohammadi Mokhtar , Mohammadi Esmaeil , Mokdad Ali H. , Moni Mohammad Ali , Moraga Paula , Morrison Shane Douglas , Mozaffari Hamid Reza , Mubarik Sumaira , Murray Christopher J. L. , Nair Tapas Sadasivan , Narasimha Swamy Sreenivas , Narayana Aparna Ichalangod , Nassereldine Hasan , Natto Zuhair S. , Nayak Biswa Prakash , Negru Serban Mircea , Nggada Haruna Asura , Nouraei Hasti , Nuñez-Samudio Virginia , Oancea Bogdan , Olagunju Andrew T. , Omar Bali Ahmed , Padron-Monedero Alicia , Padubidri Jagadish Rao , Pandey Anamika , Pardhan Shahina , Patel Jay , Pezzani Raffaele , Piracha Zahra Zahid , Rabiee Navid , Radhakrishnan Venkatraman , Radhakrishnan Raghu Anekal , Rahmani Amir Masoud , Rahmanian Vahid , Rao Chythra R. , Rao Sowmya J. , Rath Goura Kishor , Rawaf David Laith , Rawaf Salman , Rawassizadeh Reza , Razeghinia Mohammad Sadegh , Rezaei Nazila , Rezaei Negar , Rezaei Nima , Rezapour Aziz , Riad Abanoub , Roberts Thomas J. , Romero-Rodríguez Esperanza , Roshandel Gholamreza , S. Manjula , S. N. Chandan , Saddik Basema , Saeb Mohammad Reza , Saeed Umar , Safaei Mohsen , Sahebazzamani Maryam , Sahebkar Amirhossein , Salek Farrokhi Amir , Samy Abdallah M. , Santric-Milicevic Milena M. , Sathian Brijesh , Satpathy Maheswar , Šekerija Mario , Senthilkumaran Subramanian , Seylani Allen , Shafaat Omid , Shahsavari Hamid R. , Shamsoddin Erfan , Sharew Mequannent Melaku , Sharifi-Rad Javad , Shetty Jeevan K. , Shivakumar K. M. , Shobeiri Parnian , Shorofi Seyed Afshin , Shrestha Sunil , Siddappa Malleshappa Sudeep K. , Singh Paramdeep , Singh Jasvinder A. , Singh Garima , Sinha Dhirendra Narain , Solomon Yonatan , Suleman Muhammad , Suliankatchi Abdulkader Rizwan , Taheri Abkenar Yasaman , Talaat Iman M. , Tan Ker-Kan , Tbakhi Abdelghani , Thiyagarajan Arulmani , Tiyuri Amir , Tovani-Palone Marcos Roberto , Unnikrishnan Bhaskaran , Vo Bay , Volovat Simona Ruxandra , Wang Cong , Westerman Ronny , Wickramasinghe Nuwan Darshana , Xiao Hong , Yu Chuanhua , Yuce Deniz , Yunusa Ismaeel , Zadnik Vesna , Zare Iman , Zhang Zhi-Jiang , Zoladl Mohammad , Force Lisa M. , Hugo Fernando N. 
Published: September 2023

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.