Rising trends of oral cancer mortality among males worldwide: the return of an old public health problem

Oral cancer is considered widely to be a form of cancer whose etiology is well understood and which is becoming relatively rare in developed countries. There have been, however, a series of recent reports indicating that after many years of declining risk, the rates may be rising again in men. To investigate the extent of such changes, national time-series of oral-cancer mortality data available in the World Health Organization's mortality database have been analyzed. Age-period-cohort modeling was used to establish the extent and nature of these changes and to allow comparisons among countries. Nineteen out of 24 national datasets demonstrate a similar pattern of recent increasing cohort-effects for oral cancer in men. The largest increases have occurred in countries of central and eastern Europe where rates have increased by a factor of from three to 10 within a generation. The cohort-based nature of the changes observed in men suggest that there will be a continuing increase in the absolute numbers of cases of oral cancer to be treated in the coming decades.

Trends of oral cancer mortality among females worldwide

Oral cancer incidence and/or mortality has been reported to be currently increasing in several countries, particularly those of central and eastern Europe. Most of these reports pertain to men, although increases in incidence among women also have been found. In this report, data from twenty-four countries in the World Health Organization's mortality database are analyzed. The widespread increase observed in oral cancer mortality among men is not occurring in women. Nevertheless, increases have occurred in several countries in Europe, and oral-cancer death rates--especially in central and eastern Europe--are likely to increase further if tobacco smoking, in particular, becomes more popular among younger women.

Oral and pharyngeal cancer incidence in Slovakia 1968-1989

Slovakia currently has one of the highest incidence rates of oral cancer in Europe. Incidence data from the Slovakian Cancer Registry relating to oropharyngeal cancer are analyzed for the period 1968-1989 to examine trends in the incidence of these malignancies, representing the first such reported time-series from Central Europe. Over this period, rates in males have increased from 4.5 per 100,000 in 1968-1970 to 17.9 per 100,000 in 1987-1989, with more marked increases noted amongst middle-aged males (35 to 64 years), among whom rates have increased from 6.8 to 47.9 per 100,000 over the same period. Rates in women have been relatively low and stable. Changes in rates in men follow a period during the 1950s and 1960s when there was a marked increase in alcohol and tobacco consumption. The magnitude of the increases have resulted in oropharyngeal cancer becoming an important public health problem in Slovakia and emphasizes the importance of measures to prevent further increases in the consumption of tobacco and alcohol.

The descriptive epidemiology of pharyngeal cancer in Scotland

There have been recent reports of substantial increases occurring in the incidence of and/or mortality from tongue and mouth cancers in several countries. In this paper using data from Scotland (1960-89) we report on time trends in pharyngeal cancer. Similar increases in rates are evident for cancers of the oropharynx and hypopharynx while there has been little change in the occurrence of nasopharyngeal cancer (which has distinct aetiological factors). It therefore seems that reported changes in the incidence of and mortality from oral cancer may be real, and in Scotland, this is most probably due to changes in alcohol consumption.

A case-control study of oral cancer in Beijing, People's Republic of China. Associations with nutrient intakes, foods and food groups

A case-control study of oral cancer was conducted in Beijing, People's Republic of China to examine the association between dietary nutrient intake and risk of oral cancer, both in terms of estimated intake of nutrients and micro-nutrients, and in terms of specific foods and food groups. The study was hospital-based and controls were hospital in-patients matched for age and sex with the cases. The response rate for cases and controls was 100% and 404 case/control pairs were interviewed. The results suggest that increased protein and fat intake are related to a decreased risk of oral cancer. Carbohydrate intake, however, showed a moderate increased risk for oral cancer. Total carotene intake and carotene intake from fruits and vegetables are inversely associated with risk of oral cancer. A similar pattern was observed for dietary vitamin C intake. Dietary fibre derived from fruits and vegetables showed a strong negative association with oral cancer risk, but fibre derived from other sources did not exhibit any protective effect. At the level of foods and food groups, increased consumption of fresh meat, chicken and liver was significantly associated with a reduction in oral cancer risk: the tests for trend were all statistically significant at the P < 0.01 level. Consumption of common carp, hairtail, shrimp and lobster were also associated with decreased risk. Risk was found to increase with increasing consumption of millet and corn bread (P < 0.01) but to decrease with increasing consumption of rice (P < 0.01). Increased consumption of grapes, bananas, oranges, tangerines, peaches and pears were associated with reduced risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Nass use, cigarette smoking, alcohol consumption and risk of oral and oesophageal precancer

In a cross sectional study, conducted in Uzbekistan, an area with a high incidence of oral and oesophageal cancer, 1569 men were interviewed regarding use of nass quid, cigarette smoking and alcohol drinking. All subjects in the study had an oral examination, and oesophagoscopy was performed in 1344 men. Nass use and cigarette smoking emerged as independent risk factors for oral leukoplakia. The prevalence odds ratio (OR) for life-time nass intake equivalent rose from 1.0 in never-users to 5.17 [95% confidence interval (CI), 3.10-8.61] in the highest category; for total pack-years of cigarettes smoked the risk rose from 1.0 in never-smokers to 10.03 (95% CI, 4.9-20.6) in the highest category. There was a significant trend in risk (P < 0.001), for both factors. In the group with oral leukoplakia, the effect of nass use and cigarette smoking appeared to be additive. Cigarette smoking was also found to be an independent risk factor for oesophageal lesions and was significantly associated with chronic oesophagitis. The risk of chronic oesophagitis in the group with the highest pack-years of cigarettes smoked was approximately double that among non-smokers [Odds ratio (OR) = 2.47; 95% CI 1.34-4.56]. There was a weak association between nass use and oesophageal pathology: the highest life-time intake equivalent was associated with an OR of 1.56 (95% CI 1.09-2.23). Alcohol intake was not found to be independently associated with the presence of oral and oesophageal precancerous lesions.