Abstract
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.
Similar content being viewed by others
References
Parkin DM, Läärä E, Muir CS. Estimates of the world-wide frequency of sixteen major cancers in 1980.Int J Cancer 1988;41: 184–97.
Jensen O, Esteve J, Møller H, Renard H. Cancer in the European Community and its member states.Eur J Cancer 1990;26: 1167–256.
Clemmesen J.Statistical Studies in the Etiology of Malignant Neoplasms. 1: Review and Results. Copenhagen, Denmark: Munksgaard, 1965.
Case RAM, Coghill C, Davies JM, et al.Serial Mortality Tables. Neoplastic Disease. Scotland, 1911–70. Deaths and Death Rates by Sex, Age, Site and Calendar Period. London, UK: Institute of Cancer Research, Division of Epidemiology, 1976.
Case RAM, Coghill C, Davies JM, et al.Serial Mortality Tables. Neoplastic Disease. England and Wales, 1911–70. Deaths and Death Rates by Sex, Age, Site and Calendar Period. London, UK: Institute of Cancer Research, Division of Epidemiology, 1976.
Boyle P, Macfarlane GJ, Maisonneuve P, Zheng T, Scully C, Tedesco B. Epidemiology of mouth cancer in 1989: a review.J Roy Soc Med 1990;83: 724–9.
Macfarlanc GJ, Boyle P, Scully C. Oral cancer in Scotland: changing incidence and mortality.Br Med J 1992;305: 1121–3.
Møller H. Changing incidence of cancer of the tongue, oral cavity and pharynx in Denmark.J Oral Pathol Med 1989;18: 224–9.
Davis S, Severson RK. Increasing incidence of cancer of the tongue in the United States among young adults.Lancet 1987;i: 910–1.
La Vecchia C, Lucchini F, Negri E, Boyle P, Maisonneuve P, Levi F. Trends in cancer mortality in Europe, 1955–1989. I; Digestive sites.Eur J Cancer 1992;28: 132–235.
McMichael AJ, Puzio A. Time trends in upper alimentary tract cancer rates and alcohol and tobacco consumption in Australia.Community Health Stud 1988;12: 289–95.
World Health Organization.International Classification of Diseases, Injuries and Causes of Death, 9th Revision. Geneva, Switzerland: World Health Organization, 1977.
World Health Organization.International Classification of Diseases, Injuries and Causes of Death, 6th revision. Geneva, Switzerland: World Health Organization, 1950.
World Health Organization.International Classification of Diseases, Injuries and Causes of Death, 7th revision. Geneva, Switzerland: World Health Organization, 1957.
World Health Organization.International Classification of Diseases, Injuries and Causes of Death, 8th Revision. Geneva, Switzerland: World Health Organization, 1967.
Decarli A, La Vecchia C. Age, period and cohort models: A review of knowledge and implementation in GLIM.Riv Stat Appl 1987;20: 397–410.
Blot WJ, McLaughlin JK, Winn DM, et al. Smoking and drinking in relation to oral and pharyngeal cancer.Cancer Res 1988;48: 3282–7.
Negri E, La Vecchia C, Franceschi S, Tavani A. Attributable risk for oral cancer in Northern Italy.Cancer Epid Biom Prev 1993;2: 189–93.
International Agency for Research on Cancer.Tobacco Smoking. Lyon, France: IARC 1986;IARC Monogr Eval Carcinog Risks Humans, Vol. 38.
International Agency for Research on Cancer.Alcohol Drinking. Lyon, France: IARC 1988;IARC Monogr Eval Carcinog Risks Humans, Vol. 44.
Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. I. Epidemiology.Cancer Causes Control 1991;2: 325–57.
La Vecchia C, Lucchini F, Negri E, Boyle P, Maisonneuve P, Levi F. Trends of cancer mortality in Europe, 1955–1989. II: Respiratory tract, bone, connective and soft tissue sarcomas, and skin.Eur J Cancer 1992;28: 514–99.
Macfarlane GJ, Boyle P. The epidemiology of oesophageal cancer in the United Kingdom and other European countries.J Roy Soc Med 1994; in press.
Levi F, La Vecchia C, Lucchini F, Negri E, Maisonneuve P, Boyle P. Trends in cancer mortality in the Americas 1955–89.Eur J Cancer 1993;29A: 470–91.
La Vecchia C, Lucchini F, Negri E, Boyle P, Levi F. Trends in cancer mortality in 1955–89. Africa, Asia and Oceania.Eur J Cancer 1994; in press.
Boyle P, Macfarlane GJ, Scully C. Oral cancer: increasing hope for prevention.Lancet 1993;342: 1129.
Scully C, Boyle P. Vitamin A related compounds in the chemoprevention of potential malignant oral lesions and carcinoma.Eur J Cancer 1992;1B: 87–9.
Merletti F, Boffetta P, Ciccone G, Mashberg A, Terracini B. Role of tobacco and alcoholic beverages in the etiology of cancer of the oral cavity/oropharynx in Torino, Italy.Cancer Res 1989;49: 4919–24.
Author information
Authors and Affiliations
Additional information
Ms Evstifeeva is supported by a ‘Paolo Baffi’ Fellowship awarded by the Fondazione per la Formazione Oncologica, Milan, Italy.
Rights and permissions
About this article
Cite this article
Macfarlane, G.J., Boyle, P., Evstifeeva, T.V. et al. Rising trends of oral cancer mortality among males worldwide: the return of an old public health problem. Cancer Causes Control 5, 259–265 (1994). https://doi.org/10.1007/BF01830246
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01830246