Abstract
Background. Lip and oral cavity cancer (LOCC) remains a substantial global cancer burden with marked sex and geographical disparities. Updated global estimates integrating cancer burden, behavioral exposures, and socioeconomic context are needed to clarify current patterns and identify population-level priorities for prevention and control.
Methods. We conducted an ecological analysis of GLOBOCAN 2024 LOCC estimates (ICD-10 C00-C06) across 186 countries. Age-standardized incidence (ASIR) and mortality rates (ASMR) were examined by sex, region, and income level. Associations with age-standardized smoking and alcohol Summary Exposure Values and Human Development Index (HDI) indicators were evaluated using multivariable linear regression, with historical analyses based on 1990 and 2010 data.
Results. In 2024, an estimated 452,062 new LOCC cases (ASIR: 4.5 per 100,000) and 194,059 deaths (ASMR: 1.9) occurred globally, with higher ASIR and ASMR among males than females. In fully adjusted ecological models, smoking prevalence was positively associated with ASIR among females (β=0.349, p=0.012), while alcohol use was positively associated with both ASIR (β=0.275, p=0.006) and ASMR (β=0.206, p=0.046) among males. Historical analyses from 1990 and 2010 showed substantial directional concordance with contemporary associations, indicating persistent but sex-specific ecological patterns across the examined periods.
Conclusion. LOCC continues to impose a substantial and uneven global burden, with distinct sex-specific associations involving tobacco and alcohol exposure. Socioeconomic development showed no independent fully adjusted association with LOCC outcomes. These findings support context-specific prevention, sustained exposure surveillance, and stronger early detection and treatment capacity.
References
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. https://doi.org/10.3322/caac.21492.
Cunha ARD, Compton K, Xu R, Mishra R, Drangsholt MT, Antunes JLF, Kerr AR, Acheson AR, Lu D, Wallace LE, Kocarnik JM, Fu W, Dean FE, Pennini A, Henrikson HJ, Alam T, Ababneh E, Abd-Elsalam S, Abdoun M, Abidi H, Abubaker Ali H, Abu-Gharbieh E, Adane TD, Addo IY, Ahmad A, Ahmad S, Ahmed Rashid T, Akonde M, Al Hamad H, Alahdab F, Alimohamadi Y, Alipour V, Al-Maweri SA, Alsharif U, Ansari-Moghaddam A, Anwar SL, Anyasodor AE, Arabloo J, Aravkin AY, Aruleba RT, Asaad M, Ashraf T, Athari SS, Attia S, Azadnajafabad S, Azangou-Khyavy M, Badar M, Baghcheghi N, Banach M, Bardhan M, Barqawi HJ, Bashir NZ, Bashiri A, Benzian H, Bernabe E, Bhagat DS, Bhojaraja VS, Bjørge T, Bouaoud S, Braithwaite D, Briko NI, Calina D, Carreras G, Chakraborty PA, Chattu VK, Chaurasia A, Chen MX, Cho WCS, Chu DT, Chukwu IS, Chung E, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Darvishi Cheshmeh Soltani R, Darwesh AM, Debela SA, Derbew Molla M, Dessalegn FN, Dianati-Nasab M, Digesa LE, Dixit SG, Dixit A, Djalalinia S, El Sayed I, El Tantawi M, Enyew DB, Erku DA, Ezzeddini R, Fagbamigbe AF, Falzone L, Fetensa G, Fukumoto T, Gaewkhiew P, Gallus S, Gebrehiwot M, Ghashghaee A, Gill PS, Golechha M, Goleij P, Gomez RS, Gorini G, Guimaraes ALS, Gupta B, Gupta S, Gupta VB, Gupta VK, Haj-Mirzaian A, Halboub ES, Halwani R, Hanif A, Hariyani N, Harorani M, Hasani H, Hassan AM, Hassanipour S, Hassen MB, Hay SI, Hayat K, Herrera-Serna BY, Holla R, Horita N, Hosseinzadeh M, Hussain S, Ilesanmi OS, Ilic IM, Ilic MD, Isola G, Jaiswal A, Jani CT, Javaheri T, Jayarajah U, Jayaram S, Joseph N, Kadashetti V, Kandaswamy E, Karanth SD, Karaye IM, Kauppila JH, Kaur H, Keykhaei M, Khader YS, Khajuria H, Khanali J, Khatib MN, Khayat Kashani HR, Khazeei Tabari MA, Kim MS, Kompani F, Koohestani HR, Kumar GA, Kurmi OP, La Vecchia C, Lal DK, Landires I, Lasrado S, Ledda C, Lee YH, Libra M, Lim SS, Listl S, Lopukhov PD, Mafi AR, Mahumud RA, Malik AA, Mathur MR, Maulud SQ, Meena JK, Mehrabi Nasab E, Mestrovic T, Mirfakhraie R, Misganaw A, Misra S, Mithra P, Mohammad Y, Mohammadi M, Mohammadi E, Mokdad AH, Moni MA, Moraga P, Morrison SD, Mozaffari HR, Mubarik S, Murray CJL, Nair TS, Narasimha Swamy S, Narayana AI, Nassereldine H, Natto ZS, Nayak BP, Negru SM, Nggada HA, Nouraei H, Nuñez-Samudio V, Oancea B, Olagunju AT, Omar Bali A, Padron-Monedero A, Padubidri JR, Pandey A, Pardhan S, Patel J, Pezzani R, Piracha ZZ, Rabiee N, Radhakrishnan V, Radhakrishnan RA, Rahmani AM, Rahmanian V, Rao CR, Rao SJ, Rath GK, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Rezaei N, Rezaei N, Rezaei N, Rezapour A, Riad A, Roberts TJ, Romero-Rodríguez E, Roshandel G, S M, S NC, Saddik B, Saeb MR, Saeed U, Safaei M, Sahebazzamani M, Sahebkar A, Salek Farrokhi A, Samy AM, Santric-Milicevic MM, Sathian B, Satpathy M, Šekerija M, Senthilkumaran S, Seylani A, Shafaat O, Shahsavari HR, Shamsoddin E, Sharew MM, Sharifi-Rad J, Shetty JK, Shivakumar KM, Shobeiri P, Shorofi SA, Shrestha S, Siddappa Malleshappa SK, Singh P, Singh JA, Singh G, Sinha DN, Solomon Y, Suleman M, Suliankatchi Abdulkader R, Taheri Abkenar Y, Talaat IM, Tan KK, Tbakhi A, Thiyagarajan A, Tiyuri A, Tovani-Palone MR, Unnikrishnan B, Vo B, Volovat SR, Wang C, Westerman R, Wickramasinghe ND, Xiao H, Yu C, Yuce D, Yunusa I, Zadnik V, Zare I, Zhang ZJ, Zoladl M, Force LM, Hugo FN. 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. JAMA Oncol 2023;9:1401-16. https://doi.org/10.1001/jamaoncol.2023.2960.
Torres-Rosas R, Torres-Gómez N, Hernández-Juárez J, Pérez-Cervera Y, Hernández-Antonio A, Argueta-Figueroa L. Reported epidemiology of cancer of the lip, oral cavity and oropharynx in Mexico. Rev Med Inst Mex Seguro Soc 2020;58:494-507. https://doi.org/10.24875/rmimss.M20000075.
Han AY, Kuan EC, Mallen-St Clair J, Alonso JE, Arshi A, St John MA. Epidemiology of Squamous Cell Carcinoma of the Lip in the United States: A Population-Based Cohort Analysis. JAMA Otolaryngol Head Neck Surg 2016;142:1216-23. https://doi.org/10.1001/jamaoto.2016.3455.
Chi AC, Day TA, Neville BW. Oral cavity and oropharyngeal squamous cell carcinoma–an update. CA Cancer J Clin 2015;65:401-21. https://doi.org/10.3322/caac.21293.
Bastien AJ, Manzoor D, Maluf H, Balzer B, Leong M, Walgama ES, Scher KC, Jang JK, Moyers J, Clair JM, Zumsteg ZS, Ho AS. A review of histopathologic assessment for head and neck oncologists. Oral Oncol 2025;165:107286. https://doi.org/10.1016/j.oraloncology.2025.107286.
de Arruda JAA, Drumond VZ, Tenório JR, Abreu LG, Silva TA, Mesquita RA, de Andrade BAB. Oral Melanoma in Older Adults: Epidemiology, Molecular Landscape, and Treatment Strategies. Pigment Cell Melanoma Res 2025;38:e70017. https://doi.org/10.1111/pcmr.70017.
Ram H, Sarkar J, Kumar H, Konwar R, Bhatt ML, Mohammad S. Oral cancer: risk factors and molecular pathogenesis. J Maxillofac Oral Surg 2011;10:132-7. https://doi.org/10.1007/s12663-011-0195-z.
Ribeiro IL, de Medeiros JJ, Rodrigues LV, Valença AM, Lima Neto Ede A. Factors associated with lip and oral cavity cancer. Rev Bras Epidemiol 2015;18:618-29. https://doi.org/10.1590/1980-5497201500030008.
Radoï L, Paget-Bailly S, Cyr D, Papadopoulos A, Guida F, Schmaus A, Cénée S, Menvielle G, Carton M, Lapôtre-Ledoux B, Delafosse P, Stücker I, Luce D. Tobacco smoking, alcohol drinking and risk of oral cavity cancer by subsite: results of a French population-based case-control study, the ICARE study. Eur J Cancer Prev 2013;22:268-76. https://doi.org/10.1097/CEJ.0b013e3283592cce.
Petersen PE. Oral cancer prevention and control–the approach of the World Health Organization. Oral Oncol 2009;45:454-60. https://doi.org/10.1016/j.oraloncology.2008.05.023.
Muwonge R, Ramadas K, Sankila R, Thara S, Thomas G, Vinoda J, Sankaranarayanan R. Role of tobacco smoking, chewing and alcohol drinking in the risk of oral cancer in Trivandrum, India: a nested case-control design using incident cancer cases. Oral Oncol 2008;44:446-54. https://doi.org/10.1016/j.oraloncology.2007.06.002.
Guha N, Warnakulasuriya S, Vlaanderen J, Straif K. Betel quid chewing and the risk of oral and oropharyngeal cancers: a meta-analysis with implications for cancer control. Int J Cancer 2014;135:1433-43. https://doi.org/10.1002/ijc.28643.
Chuang HC, Tsai MH, Lin YT, Chou MH, Yang KL, Chien CY. Systemic and Local Effects Among Patients With Betel Quid-Related Oral Cancer. Technol Cancer Res Treat 2022;21:15330338221146870. https://doi.org/10.1177/15330338221146870.
Huang J, Chan SC, Ko S, Lok V, Zhang L, Lin X, Lucero-Prisno DE, 3rd, Xu W, Zheng ZJ, Elcarte E, Withers M, Wong MCS. Disease burden, risk factors, and trends of lip, oral cavity, pharyngeal cancers: A global analysis. Cancer Med 2023;12:18153-64. https://doi.org/10.1002/cam4.6391.
Miranda-Filho A, Bray F. Global patterns and trends in cancers of the lip, tongue and mouth. Oral Oncol 2020;102:104551. https://doi.org/10.1016/j.oraloncology.2019.104551.
Du M, Nair R, Jamieson L, Liu Z, Bi P. Incidence Trends of Lip, Oral Cavity, and Pharyngeal Cancers: Global Burden of Disease 1990-2017. J Dent Res 2020;99:143-151. https://doi.org/10.1177/0022034519894963.
Cao W, Qin K, Li F, Chen W. Socioeconomic inequalities in cancer incidence and mortality: An analysis of GLOBOCAN 2022. Chin Med J (Engl) 2024;137:1407-13. https://doi.org/10.1097/cm9.0000000000003140.
Mohammadian M, Allah Bakeshei K, Mohammadian-Hafshejani A. International epidemiology of liver cancer: geographical distribution, secular trends and predicting the future. J Prev Med Hyg 2020;61:E259-89. https://doi.org/10.15167/2421-4248/jpmh2020.61.2.1244.
Fidler MM, Soerjomataram I, Bray F. A global view on cancer incidence and national levels of the human development index. Int J Cancer 2016;139:2436-46. https://doi.org/10.1002/ijc.30382.
Rafiemanesh H, Mehtarpoor M, Mohammadian-Hafshejani A, Salehiniya H, Enayatrad M, Khazaei S. Cancer epidemiology and trends in Sistan and Baluchestan province, Iran. Med J Islam Repub Iran 2015;29:254.
Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008-2030): a population-based study. Lancet Oncol 2012;13:790-801. https://doi.org/10.1016/s1470-2045(12)70211-5.
Ru G. Strategies of epidemiologic research applied to BSE. Epidemiol Prev 1999;23:378-82.
Sung H, Filho AM, Laversanne M, Ferlay J, Siegel RL, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2024: GLOBOCAN estimates of incidence and mortality worldwide for 34 cancers in 186 countries. CA Cancer J Clin 2026;76:e70090. https://doi.org/10.3322/caac.70090.
Bertuccio P, Alicandro G, Malvezzi M, Carioli G, Boffetta P, Levi F, La Vecchia C, Negri E. Cancer mortality in Europe in 2015 and an overview of trends since 1990. Annals of oncology: official journal of the European Society for Medical Oncology 2019;30:1356-69. https://doi.org/10.1093/annonc/mdz179.
Petrick JL, Florio AA, Znaor A, Ruggieri D, Laversanne M, Alvarez CS, Ferlay J, Valery PC, Bray F, McGlynn KA. International trends in hepatocellular carcinoma incidence, 1978-2012. Int J Cancer 2020;147:317-30. https://doi.org/10.1002/ijc.32723.
Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396:1223-49. https://doi.org/10.1016/s0140-6736(20)30752-2.
Programme UND: Human development report 2025: A matter of choice: People and possibilities in the age of AI: Stylus Publishing, LLC 2025.
Sartori LRM, Nóbrega KHS, Schuch HS, Cademartori MG, de Arruda JAA, Martins MD, Schuch LF, Vasconcelos ACU. Temporal trends of women with oral cavity, base of tongue and lip cancers in Brazil: An ecological study covering mortality data from 1980 to 2018. Community Dent Oral Epidemiol 2023;51:236-46. https://doi.org/10.1111/cdoe.12731.
Peres MA, Li H, Nascimento GG, Leite FRM. Incidence, mortality and survival rates of lip, oral cavity and salivary glands cancers in Singapore: A half-century time trend analysis (1968-2017). Community Dent Oral Epidemiol 2024;52:302-12. https://doi.org/10.1111/cdoe.12951.
Dai X, Liang Y. Tobacco- and alcohol-attributable burden of early-onset lip, oral cavity, and pharyngeal cancer in 204 countries and territories from 1990 to 2019, with projections to 2040. Front Oncol 2024;14:1429972. https://doi.org/10.3389/fonc.2024.1429972.
Yu Z, Ma X, Xiao H, Chen Y, Wu Y, He J, Cheng P. Disease burden and attributable risk factors of lip and oral cavity cancer in China from 1990 to 2021 and its prediction to 2031. Front Public Health 2024;12:1419428. https://doi.org/10.3389/fpubh.2024.1419428.
Weatherspoon DJ, Chattopadhyay A, Boroumand S, Garcia I. Oral cavity and oropharyngeal cancer incidence trends and disparities in the United States: 2000-2010. Cancer Epidemiol 2015;39:497-504. https://doi.org/10.1016/j.canep.2015.04.007.
Kocarnik JM, Compton K, Dean FE, Fu W, Gaw BL, Harvey JD, Henrikson HJ, Lu D, Pennini A, Xu R, Ababneh E, Abbasi-Kangevari M, Abbastabar H, Abd-Elsalam SM, Abdoli A, Abedi A, Abidi H, Abolhassani H, Adedeji IA, Adnani QES, Advani SM, Afzal MS, Aghaali M, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed Rashid T, Ahmed Salih Y, Akalu GT, Aklilu A, Akram T, Akunna CJ, Al Hamad H, Alahdab F, Al-Aly Z, Ali S, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almasi-Hashiani A, Almasri NA, Al-Maweri SAA, Almustanyir S, Alonso N, Alvis-Guzman N, Amu H, Anbesu EW, Ancuceanu R, Ansari F, Ansari-Moghaddam A, Antwi MH, Anvari D, Anyasodor AE, Aqeel M, Arabloo J, Arab-Zozani M, Aremu O, Ariffin H, Aripov T, Arshad M, Artaman A, Arulappan J, Asemi Z, Asghari Jafarabadi M, Ashraf T, Atorkey P, Aujayeb A, Ausloos M, Awedew AF, Ayala Quintanilla BP, Ayenew T, Azab MA, Azadnajafabad S, Azari Jafari A, Azarian G, Azzam AY, Badiye AD, Bahadory S, Baig AA, Baker JL, Balakrishnan S, Banach M, Bärnighausen TW, Barone-Adesi F, Barra F, Barrow A, Behzadifar M, Belgaumi UI, Bezabhe WMM, Bezabih YM, Bhagat DS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bisignano C, Bjørge T, Bleyer A, Blyuss O, Bolarinwa OA, Bolla SR, Braithwaite D, Brar A, Brenner H, Bustamante-Teixeira MT, Butt NS, Butt ZA, Caetano Dos Santos FL, Cao Y, Carreras G, Catalá-López F, Cembranel F, Cerin E, Cernigliaro A, Chakinala RC, Chattu SK, Chattu VK, Chaturvedi P, Chimed-Ochir O, Cho DY, Christopher DJ, Chu DT, Chung MT, Conde J, Cortés S, Cortesi PA, Costa VM, Cunha AR, Dadras O, Dagnew AB, Dahlawi SMA, Dai X, Dandona L, Dandona R, Darwesh AM, das Neves J, De la Hoz FP, Demis AB, Denova-Gutiérrez E, Dhamnetiya D, Dhimal ML, Dhimal M, Dianatinasab M, Diaz D, Djalalinia S, Do HP, Doaei S, Dorostkar F, Dos Santos Figueiredo FW, Driscoll TR, Ebrahimi H, Eftekharzadeh S, El Tantawi M, El-Abid H, Elbarazi I, Elhabashy HR, Elhadi M, El-Jaafary SI, Eshrati B, Eskandarieh S, Esmaeilzadeh F, Etemadi A, Ezzikouri S, Faisaluddin M, Faraon EJA, Fares J, Farzadfar F, Feroze AH, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Fisher JL, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gadanya MA, Gallus S, Gaspar Fonseca M, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gholamalizadeh M, Gilani SA, Ginindza TG, Gizaw ATT, Glasbey JC, Golechha M, Goleij P, Gomez RS, Gopalani SV, Gorini G, Goudarzi H, Grosso G, Gubari MIM, Guerra MR, Guha A, Gunasekera DS, Gupta B, Gupta VB, Gupta VK, Gutiérrez RA, Hafezi-Nejad N, Haider MR, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hanif A, Haque S, Harlianto NI, Haro JM, Hasaballah AI, Hassanipour S, Hay RJ, Hay SI, Hayat K, Heidari G, Heidari M, Herrera-Serna BY, Herteliu C, Hezam K, Holla R, Hossain MM, Hossain MBH, Hosseini MS, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huang J, Hugo FN, Hussain R, Hussein NR, Hwang BF, Iavicoli I, Ibitoye SE, Ida F, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Irham LM, Islam JY, Islam RM, Islam SMS, Ismail NE, Isola G, Iwagami M, Jacob L, Jain V, Jakovljevic MB, Javaheri T, Jayaram S, Jazayeri SB, Jha RP, Jonas JB, Joo T, Joseph N, Joukar F, Jürisson M, Kabir A, Kahrizi D, Kalankesh LR, Kalhor R, Kaliyadan F, Kalkonde Y, Kamath A, Kameran Al-Salihi N, Kandel H, Kapoor N, Karch A, Kasa AS, Katikireddi SV, Kauppila JH, Kavetskyy T, Kebede SA, Keshavarz P, Keykhaei M, Khader YS, Khalilov R, Khan G, Khan M, Khan MN, Khan MAB, Khang YH, Khater AM, Khayamzadeh M, Kim GR, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Kopec JA, Koteeswaran R, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Kucuk Bicer B, Kugbey N, Kumar GA, Kumar N, Kumar N, Kurmi OP, Kutluk T, La Vecchia C, Lami FH, Landires I, Lauriola P, Lee SW, Lee SWH, Lee WC, Lee YH, Leigh J, Leong E, Li J, Li MC, Liu X, Loureiro JA, Lunevicius R, Magdy Abd El Razek M, Majeed A, Makki A, Male S, Malik AA, Mansournia MA, Martini S, Masoumi SZ, Mathur P, McKee M, Mehrotra R, Mendoza W, Menezes RG, Mengesha EW, Mesregah MK, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mirzaei H, Mirzaei HR, Misra S, Mithra P, Moghadaszadeh M, Mohammad KA, Mohammad Y, Mohammadi M, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Moka N, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moosavi MA, Moradi Y, Moraga P, Morgado-da-Costa J, Morrison SD, Mosapour A, Mubarik S, Mwanri L, Nagarajan AJ, Nagaraju SP, Nagata C, Naimzada MD, Nangia V, Naqvi AA, Narasimha Swamy S, Ndejjo R, Nduaguba SO, Negoi I, Negru SM, Neupane Kandel S, Nguyen CT, Nguyen HLT, Niazi RK, Nnaji CA, Noor NM, Nuñez-Samudio V, Nzoputam CI, Oancea B, Ochir C, Odukoya OO, Ogbo FA, Olagunju AT, Olakunde BO, Omar E, Omar Bali A, Omonisi AEE, Ong S, Onwujekwe OE, Orru H, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Owolabi MO, P AM, Padubidri JR, Pakshir K, Pana A, Panagiotakos D, Panda-Jonas S, Pardhan S, Park EC, Park EK, Pashazadeh Kan F, Patel HK, Patel JR, Pati S, Pattanshetty SM, Paudel U, Pereira DM, Pereira RB, Perianayagam A, Pillay JD, Pirouzpanah S, Pishgar F, Podder I, Postma MJ, Pourjafar H, Prashant A, Preotescu L, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Radhakrishnan V, Rafiee A, Rahim F, Rahimzadeh S, Rahman M, Rahman MA, Rahmani AM, Rajai N, Rajesh A, Rakovac I, Ram P, Ramezanzadeh K, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezapour A, Roberts TJ, Rodriguez JAB, Rohloff P, Romoli M, Ronfani L, Roshandel G, Rwegerera GM, S M, Sabour S, Saddik B, Saeed U, Sahebkar A, Sahoo H, Salehi S, Salem MR, Salimzadeh H, Samaei M, Samy AM, Sanabria J, Sankararaman S, Santric-Milicevic MM, Sardiwalla Y, Sarveazad A, Sathian B, Sawhney M, Saylan M, Schneider IJC, Sekerija M, Seylani A, Shafaat O, Shaghaghi Z, Shaikh MA, Shamsoddin E, Shannawaz M, Sharma R, Sheikh A, Sheikhbahaei S, Shetty A, Shetty JK, Shetty PH, Shibuya K, Shirkoohi R, Shivakumar KM, Shivarov V, Siabani S, Siddappa Malleshappa SK, Silva DAS, Singh JA, Sintayehu Y, Skryabin VY, Skryabina AA, Soeberg MJ, Sofi-Mahmudi A, Sotoudeh H, Steiropoulos P, Straif K, Subedi R, Sufiyan MB, Sultan I, Sultana S, Sur D, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tabuchi T, Tadbiri H, Taherkhani A, Takahashi K, Talaat IM, Tan KK, Tat VY, Tedla BAA, Tefera YG, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tessema GA, Thapar R, Thavamani A, Thoguluva Chandrasekar V, Thomas N, Tohidinik HR, Touvier M, Tovani-Palone MR, Traini E, Tran BX, Tran KB, Tran MTN, Tripathy JP, Tusa BS, Ullah I, Ullah S, Umapathi KK, Unnikrishnan B, Upadhyay E, Vacante M, Vaezi M, Valadan Tahbaz S, Velazquez DZ, Veroux M, Violante FS, Vlassov V, Vo B, Volovici V, Vu GT, Waheed Y, Wamai RG, Ward P, Wen YF, Westerman R, Winkler AS, Yadav L, Yahyazadeh Jabbari SH, Yang L, Yaya S, Yazie TSY, Yeshaw Y, Yonemoto N, Younis MZ, Yousefi Z, Yu C, Yuce D, Yunusa I, Zadnik V, Zare F, Zastrozhin MS, Zastrozhina A, Zhang J, Zhong C, Zhou L, Zhu C, Ziapour A, Zimmermann IR, Fitzmaurice C, Murray CJL, Force LM. Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol 2022;8:420-44. https://doi.org/10.1001/jamaoncol.2021.6987.
Braakhuis BJ, Visser O, Leemans CR. Oral and oropharyngeal cancer in The Netherlands between 1989 and 2006: Increasing incidence, but not in young adults. Oral Oncol 2009;45:e85-9. https://doi.org/10.1016/j.oraloncology.2009.03.010.
Hussein AA, Helder MN, de Visscher JG, Leemans CR, Braakhuis BJ, de Vet HCW, Forouzanfar T. Global incidence of oral and oropharynx cancer in patients younger than 45 years versus older patients: A systematic review. Eur J Cancer 2017;82:115-27. https://doi.org/10.1016/j.ejca.2017.05.026.
Proia NK, Paszkiewicz GM, Nasca MA, Franke GE, Pauly JL. Smoking and smokeless tobacco-associated human buccal cell mutations and their association with oral cancer–a review. Cancer Epidemiol Biomarkers Prev 2006;15:1061-77. https://doi.org/10.1158/1055-9965.Epi-05-0983.
Petti S. Lifestyle risk factors for oral cancer. Oral Oncol 2009;45:340-50. https://doi.org/10.1016/j.oraloncology.2008.05.018.
Gupta AK, Kanaan M, Siddiqi K, Sinha DN, Mehrotra R. Oral Cancer Risk Assessment for Different Types of Smokeless Tobacco Products Sold Worldwide: A Review of Reviews and Meta-analyses. Cancer Prev Res (Phila) 2022;15:733-46. https://doi.org/10.1158/1940-6207.Capr-21-0567.
Barasch A, Morse DE, Krutchkoff DJ, Eisenberg E. Smoking, gender, and age as risk factors for site-specific intraoral squamous cell carcinoma. A case-series analysis. Cancer 1994;73:509-13. https://doi.org/10.1002/1097-0142(19940201)73:3<509::AID-CNCR2820730303>3.0.CO;2-X.
Zhu S, Zhang F, Zhao G, Zhang X, Zhang X, Li T, Hu C, Zhu W, Li D. Trends in the global burden of oral cancer joint with attributable risk factors: Results from the global burden of disease study 2019. Oral Oncol 2022;134:106189. https://doi.org/10.1016/j.oraloncology.2022.106189.
Batistella E, Gondak R, Rivero ERC, Warnakulasuriya S, Guerra E, Porporatti AL, De Luca Canto G. Comparison of tobacco and alcohol consumption in young and older patients with oral squamous cell carcinoma: a systematic review and meta-analysis. Clin Oral Investig 2022;26:6855-69. https://doi.org/10.1007/s00784-022-04719-z.
Eloranta R, Vilén ST, Keinänen A, Salo T, Qannam A, Bello IO, Snäll J. Oral squamous cell carcinoma: Effect of tobacco and alcohol on cancer location. Tob Induc Dis 2024;22. https://doi.org/10.18332/tid/189303.
Yang Z, Sun P, Dahlstrom KR, Gross N, Li G. Joint effect of human papillomavirus exposure, smoking and alcohol on risk of oral squamous cell carcinoma. BMC Cancer 2023;23:457. https://doi.org/10.1186/s12885-023-10948-6.
Wang X, Xu J, Wang L, Liu C, Wang H. The role of cigarette smoking and alcohol consumption in the differentiation of oral squamous cell carcinoma for the males in China. J Cancer Res Ther 2015;11:141-5. https://doi.org/10.4103/0973-1482.137981.
Hashibe M, Brennan P, Chuang SC, Boccia S, Castellsague X, Chen C, Curado MP, Dal Maso L, Daudt AW, Fabianova E, Fernandez L, Wünsch-Filho V, Franceschi S, Hayes RB, Herrero R, Kelsey K, Koifman S, La Vecchia C, Lazarus P, Levi F, Lence JJ, Mates D, Matos E, Menezes A, McClean MD, Muscat J, Eluf-Neto J, Olshan AF, Purdue M, Rudnai P, Schwartz SM, Smith E, Sturgis EM, Szeszenia-Dabrowska N, Talamini R, Wei Q, Winn DM, Shangina O, Pilarska A, Zhang ZF, Ferro G, Berthiller J, Boffetta P. Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev 2009;18:541-50. https://doi.org/10.1158/1055-9965.Epi-08-0347.
Castellsagué X, Quintana MJ, Martínez MC, Nieto A, Sánchez MJ, Juan A, Monner A, Carrera M, Agudo A, Quer M, Muñoz N, Herrero R, Franceschi S, Bosch FX. The role of type of tobacco and type of alcoholic beverage in oral carcinogenesis. Int J Cancer 2004;108:741-9. https://doi.org/10.1002/ijc.11627.
Lubin JH, Gaudet MM, Olshan AF, Kelsey K, Boffetta P, Brennan P, Castellsague X, Chen C, Curado MP, Dal Maso L, Daudt AW, Fabianova E, Fernandez L, Wünsch-Filho V, Franceschi S, Herrero R, Koifman S, La Vecchia C, Lazarus P, Levi F, Lissowska J, Mates IN, Matos E, McClean M, Menezes A, Morgenstern H, Muscat J, Eluf Neto J, Purdue MP, Rudnai P, Schwartz SM, Shangina O, Sturgis EM, Szeszenia-Dabrowska N, Talamini R, Wei Q, Winn D, Zhang ZF, Hashibe M, Hayes RB. Body mass index, cigarette smoking, and alcohol consumption and cancers of the oral cavity, pharynx, and larynx: modeling odds ratios in pooled case-control data. Am J Epidemiol 2010;171:1250-61. https://doi.org/10.1093/aje/kwq088.
Hernández-Morales A, González-López BS, Scougall-Vilchis RJ, Bermeo-Escalona JR, Velázquez-Enríquez U, Islas-Zarazúa R, Márquez-Rodríguez S, Sosa-Velasco TA, Medina-Solís CE, Maupomé G. Lip and Oral Cavity Cancer Incidence and Mortality Rates Associated with Smoking and Chewing Tobacco Use and the Human Development Index in 172 Countries Worldwide: An Ecological Study 2019-2020. Healthcare (Basel) 2023;11. https://doi.org/10.3390/healthcare11081063.
Lara-Carrillo E, Herrera-Serna BY, Conzuelo-Rodríguez G, do Amaral RC, Aguilera-Eguía RA, Toral-Rizo VH. Effect of Human Development Index and other socioeconomic factors on mortality-to-incidence ratio of lips and oral cavity cancer in Mexican states: an ecological study. BMJ Open 2021;11:e042376. https://doi.org/10.1136/bmjopen-2020-042376.
Rajappa S, Singh M, Uehara R, Schachterle SE, Setia S. Cancer incidence and mortality trends in Asia based on regions and human development index levels: an analyses from GLOBOCAN 2020. Curr Med Res Opin 2023;39:1127-37. https://doi.org/10.1080/03007995.2023.2231761.
Sung WW, Hsu YC, Dong C, Chen YC, Chao YC, Chen CJ. Favorable Lip and Oral Cancer Mortality-to-Incidence Ratios in Countries with High Human Development Index and Expenditures on Health. Int J Environ Res Public Health 2021;18. https://doi.org/10.3390/ijerph18116012.
Sofi-Mahmudi A, Masinaei M, Shamsoddin E, Tovani-Palone MR, Heydari MH, Shoaee S, Ghasemi E, Azadnajafabad S, Roshani S, Rezaei N, Rashidi MM, Kalantar Mehrjardi R, Hajebi AA, Larijani B, Farzadfar F. Global, regional, and national burden and quality of care index (QCI) of lip and oral cavity cancer: a systematic analysis of the Global Burden of Disease Study 1990-2017. BMC Oral Health 2021;21:558. https://doi.org/10.1186/s12903-021-01918-0.
Syrjänen S. Human papillomavirus (HPV) in head and neck cancer. J Clin Virol 2005;32 Suppl 1:S59-66. https://doi.org/10.1016/j.jcv.2004.11.017.
Worakhajit P, Fuangtharnthip P, Khovidhunkit SP, Chiewwit P, Klongnoi B. The Relationship of Tobacco, Alcohol, and Betel Quid with the Formation of Oral Potentially Malignant Disorders: A Community-Based Study from Northeastern Thailand. Int J Environ Res Public Health 2021;18. https://doi.org/10.3390/ijerph18168738.
Chiewwit P, Khovidhunkit SP, Tantipoj C, Worakhajit P, Klongnoi B. A study of risk factors associated with the presence of oral potentially malignant disorders: a community-based study from Northeastern Thailand. BMC Oral Health 2024;24:932. https://doi.org/10.1186/s12903-024-04554-6.
Harris JA, Ritchie CA, Hanna GJ, McCain JP, Ji YD. The Inequitable Global Burden of Lip and Oral Cancers: Widening Disparities Across Countries. J Oral Maxillofac Surg 2021;79:1364-72. https://doi.org/10.1016/j.joms.2020.12.035.
Bosetti C, Carioli G, Santucci C, Bertuccio P, Gallus S, Garavello W, Negri E, La Vecchia C. Global trends in oral and pharyngeal cancer incidence and mortality. Int J Cancer 2020;147:1040-9. https://doi.org/10.1002/ijc.32871.
Ghanem AS, Memon HA, Nagy AC. Evolving trends in oral cancer burden in Europe: a systematic review. Front Oncol 2024;14:1444326. https://doi.org/10.3389/fonc.2024.1444326.
Gupta A, Sonis S, Uppaluri R, Bergmark RW, Villa A. Disparities in Oral Cancer Screening Among Dental Professionals: NHANES 2011-2016. Am J Prev Med 2019;57:447-57. https://doi.org/10.1016/j.amepre.2019.04.026.
Iwata AJ, Williams AM, Taylor AR, Chang SS. Socioeconomic disparities and comorbidities, not race, affect salivary gland malignancy survival outcomes. Laryngoscope 2017;127:2545-50. https://doi.org/10.1002/lary.26633.
Giraldi L, Collatuzzo G, Hashim D, Franceschi S, Herrero R, Chen C, Schwartz SM, Smith E, Kelsey K, McClean M, Gillison M, Boccia S, Hashibe M, Amy Lee YC, Boffetta P. Infection with Human Papilloma Virus (HPV) and risk of subsites within the oral cancer. Cancer Epidemiol 2021;75:102020. https://doi.org/10.1016/j.canep.2021.102020.
Wang G, Yu Z, Ji T, Shi L, Liu W. A scientometric study of betel quid chewing and oral cancer and precancerous lesions with distinct regional characteristic. J Dent Sci 2023;18:1378-83. https://doi.org/10.1016/j.jds.2023.03.007.
Chaturvedi AK, Freedman ND, Abnet CC. The Evolving Epidemiology of Oral Cavity and Oropharyngeal Cancers. Cancer Res 2022;82:2821-3. https://doi.org/10.1158/0008-5472.Can-22-2124.
Cheung LC, Ramadas K, Muwonge R, Katki HA, Thomas G, Graubard BI, Basu P, Sankaranarayanan R, Somanathan T, Chaturvedi AK. Risk-Based Selection of Individuals for Oral Cancer Screening. J Clin Oncol 2021;39:663-74. https://doi.org/10.1200/jco.20.02855.
LeHew CW, Weatherspoon DJ, Peterson CE, Goben A, Reitmajer K, Sroussi H, Kaste LM. The Health System and Policy Implications of Changing Epidemiology for Oral Cavity and Oropharyngeal Cancers in the United States From 1995 to 2016. Epidemiol Rev 2017;39:132-47. https://doi.org/10.1093/epirev/mxw001.
