The Health System and Policy Implications of Changing Epidemiology for Oral Cavity and Oropharyngeal Cancers in the United States From 1995 to 2016

Abstract

Oral cavity and oropharyngeal cancers are typically grouped under the general term, "oral cancer." Yet, the incidence of oropharyngeal cancers is increasing in the United States, while the incidence of oral cavity cancers has declined. These 2 distinct but conflated groups of oral cancers are attributed to different risk factors. Incidence and survival trends were examined across US population groups and by anatomical subsite. Disparities in incidence and survival by sex, race/ethnicity, and subsite were identified. Risk factors are complex, interactive, and not fully identified. Cancer control research illustrates health disparities in access to care and patient outcomes. Database and supplemental searches yielded 433 articles published between 1995 and 2016 characterizing aspects of oral cancer epidemiology relating to incidence, survival, risk, disparities, and cancer control. Oral cavity cancer survival in black men remains the most intractable burden. Although understanding of oral cancer etiology is improving, application to policy is limited. Cancer control efforts are diverse, sporadic, limited in scope, and generally lacking in success, and they need stratification by oral cavity cancers/oropharyngeal cancers. Further intervention and epidemiologic research, improved workforce capacity, and integrated care delivery are identified as important directions for public health policy. Sustained, multilevel campaigns modeled on tobacco control success are suggested.

Extracapsular extension of neck nodes and absence of human papillomavirus 16‐DNA are predictors of impaired survival in p16‐positive oropharyngeal squamous cell carcinoma

“…The main risk factors for developing OPSCC are tobacco use and excessive alcohol consumption . Although, in the Western world, tobacco use is (slowly) decreasing, especially among men, increases in the number of patients with OPSCC who are infected by oncogenic high‐risk subtypes of the human papillomavirus (HPV) (namely, HPV type 16 [HPV16]) have been observed in recent decades and have been identified as an important risk factor for OPSCC, especially for OPSCC of the tonsils . The disease‐free survival (DFS), tumor‐specific survival (TSS), and overall survival (OS) of patients who have HPV‐related OPSCC is superior compared with the survival of those who have HPV‐negative OPSCC, because their cancer often is not etiologically linked to tobacco smoking or high rates of alcohol consumption .…”

Racial disparities and human papillomavirus status in oropharyngeal cancer: A systematic review and meta‐analysis

“…Much of current literature acknowledges a disparity in overall survival between black and white patients with oropharyngeal squamous cell cancer (OPSCC) . Many factors have been implicated in the reason for disparity, including higher stage at presentation, comorbidities, socioeconomic status, treatment differences, and human papillomavirus (HPV) status .…”

Early Detection and Multidisciplinary Approach to Oral Cancer Patients

“…"Oral cancer" is a term usually used to describe oral cavity and oropharyngeal malign tumors. Oropharyngeal cancers include the regions known as buccal mucosa, hard-soft palate, and floor of mouth-gums, tonsils, and base and oral tongue remain oropharynx regions [1]. Despite this, the typical use of the term "oropharyngeal cancer" is unsuitable for this current topic due to earlier determination of "oral cancer."…”

“…Despite this, the typical use of the term "oropharyngeal cancer" is unsuitable for this current topic due to earlier determination of "oral cancer." Although some reverse knowledge is in the literature, incidence of pharyngeal cancers is increasing, while oral cancer is declining in the USA according to the recent LeHew et al report [1]. In addition, they connected this issue to human papillomavirus (HPV) and how it may cause many more pharyngeal cancers than oral cancers, while heavy alcohol consumption and tobacco use also cause more oral cancer.…”

“…In addition, they connected this issue to human papillomavirus (HPV) and how it may cause many more pharyngeal cancers than oral cancers, while heavy alcohol consumption and tobacco use also cause more oral cancer. The same author emphasized ethnicity, gender, age, and other demographic factors that influence the occurrence of pharyngeal or oral cancers [1][2][3][4]. The other paper published by Yadav [2] mentioned the increase of oral or mouth cancer in young individuals, especially female individuals, and that lifestyles affect the likelihood it occurs (such as smoking or chewing tobacco, chewing betel nuts).…”