Epidemiology and types of oral cancer

Rajeh M. Al-Sharif, Dalia Y. Batwa, Turki N. Alotaibi, Naif M. Alwadai, Abdullah H. Alsharif, Nedaa A. Azhar, Arjumand A. Moulana, Shoroug M. Alahmadi, Meshal Y. Althobaiti, Duaa F. Bayyumi, Wejdan I. Alzahrani


Oral cancer is a subset of head and neck cancer and usually refers to different neoplastic conditions that impact any tissue within the oral cavity. Evidence shows that these malignancies are associated with different complications over the affected patients. The present literature review will discuss the epidemiology and types of oral cancer based on evidence from relevant studies within the literature. Estimates show that oral cancer is a common condition with high prevalence rates globally. However, we have identified several factors across the different relevant investigations, including smoking, alcohol intake, age, socioeconomic status, immunocompromised state, and genetics. This might explain the inconsistent findings regarding the prevalence and mortality rates of the conditions among worldwide studies. Moreover, squamous cells carcinoma is the commonest type of oral cancer. However, other types might also be identified as adenocarcinoma, sarcoma, melanoma, and lymphoma. These lesions can also be found at different places within the mouth cavity, including lips, tongue, and salivary glands. Therefore, healthcare authorities should plan adequate interventional strategies targeting the risk factors to properly control the disease and reduce its burden.


Oral cancer, Cancer lip, Cancer tongue, epidemiology, Type, Risk factors

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Zinat Motlagh SF, Chaman R, Ghafari SR, Parisay Z, Golabi MR, Eslami AA, Babouei A. Knowledge, Treatment, Control, and Risk Factors for Hypertension among Adults in Southern Iran. Int J Hypertens. 2015;897070.

Boutayeb A. The Burden of Communicable and Non-Communicable Diseases in Developing Countries. Handbook of Disease Burdens and Quality of Life Measures. 2010;531-46.

Kim HC, Oh SM. Noncommunicable diseases: current status of major modifiable risk factors in Korea. J Prevent Med Public Health. 2013;46(4):165-72.

Khang YH. Burden of noncommunicable diseases and national strategies to control them in Korea. J Prevent Med Public Health. 2013;46(4):155-64.

Taghibakhsh M, Farhadi S, Babaee A, Sheikhi M. The Effect of Hookah Use on Buccal Mucosa: Evaluation of Repair Index. Asian Pacific J Cancer Prev. 2019;20(4):1109-12.

Al-Jaber A, Al-Nasser L, El-Metwally A. Epidemiology of oral cancer in Arab countries. Saudi Med J. 2016;37(3):249-55.

Shrestha AD, Vedsted P, Kallestrup P, Neupane D. Prevalence and incidence of oral cancer in low- and middle-income countries: A scoping review. Eur J Cancer Care. 2020;29(2):e13207.

Jeihooni AK, Dindarloo SF, Harsini PA. Effectiveness of Health Belief Model on Oral Cancer Prevention in Smoker Men. J Cancer Educ. 2019;34(5):920-7.

Montero PH, Patel SG. Cancer of the oral cavity. Surg Oncol Clin North Am. 2015;24(3):491-508.

Abati S, Bramati C, Bondi S, Lissoni A, Trimarchi M. Oral Cancer and Precancer: A Narrative Review on the Relevance of Early Diagnosis. Int J Env Res Public Health. 2020;17(24).

Hung LC, Kung PT, Lung CH, Tsai MH, Liu SA, Chiu LT, et al. Assessment of the Risk of Oral Cancer Incidence in A High-Risk Population and Establishment of A Predictive Model for Oral Cancer Incidence Using A Population-Based Cohort in Taiwan. Int J Environ Res Public Health. 2020;17(2):665.

Hashibe M, Brennan P, Benhamou S, Castellsague X, Chen C, Curado MP, et al. Alcohol drinking in never users of tobacco, cigarette smoking in never drinkers, and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. J Natl Cancer Inst. 2007;99(10):777-89.

Hashibe M, Brennan P, Chuang SC, Boccia S, Castellsague X, Chen C, et al. 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(2):541-50.

Gupta B, Johnson NW. Systematic review and meta-analysis of association of smokeless tobacco and of betel quid without tobacco with incidence of oral cancer in South Asia and the Pacific. PloS One. 2014;9(11):e113385.

Siddiqi K, Gupta PC, Prasad VM, Croucher R, Sheikh A. Smokeless tobacco use by south Asians. Lancet Global Health. 2013;1(2):71.

Marron M, Boffetta P, Zhang ZF, Zaridze D, Wünsch-Filho V, Winn DM, et al. Cessation of alcohol drinking, tobacco smoking and the reversal of head and neck cancer risk. Int J Epidemiol. 2010;39(1):182-96.

Sawair FA, Al-Mutwakel A, Al-Eryani K, Al-Surhy A, Maruyama S, Cheng J, Al-Sharabi A, Saku T. High relative frequency of oral squamous cell carcinoma in Yemen: qat and tobacco chewing as its aetiological background. Int J Environ Health Res. 2007;17(3):185-95.

Al-Ghamdi SA, Malatani T, Kameswaran M, Khurana P. Head and neck cancer in a referral center in Asir region. Ann Saudi Med. 1994;14(5):383-6.

Ibrahim EM, Satti MB, Al Idrissi HY, Higazi MM, Magbool GM, Al Quorain A. Oral cancer in Saudi Arabia: the role of alqat and alshammah. Cancer Detect Prev. 1986;9(3-4):215-8.

Conway DI, Brenner DR, McMahon AD, Macpherson LM, Agudo A, Ahrens W, et al. Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries. Int J Cancer. 2015;136(5):1125-39.

Gaudet MM, Olshan AF, Chuang SC, Berthiller J, Zhang ZF, Lissowska J, et al. Body mass index and risk of head and neck cancer in a pooled analysis of case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. Int J Epidemiol. 2010;39(4):1091-102.

Winn DM, Lee YC, Hashibe M, Boffetta P. The INHANCE consortium: toward a better understanding of the causes and mechanisms of head and neck cancer. Oral Dis. 2015;21(6):685-93.

Toporcov TN, Znaor A, Zhang ZF, Yu GP, Winn DM, Wei Q, et al. Risk factors for head and neck cancer in young adults: a pooled analysis in the INHANCE consortium. Int J Epidemiol. 2015;44(1):169-85.

Conway DI, Robertson C, Gray H, Young L, McDaid LM, Winter AJ, et al. Human Papilloma Virus (HPV) Oral Prevalence in Scotland (HOPSCOTCH): A Feasibility Study in Dental Settings. PLoS One. 2016;11(11):e0165847.

Gillison ML, Chaturvedi AK, Anderson WF, Fakhry C. Epidemiology of human papillomavirus–positive head and neck squamous cell carcinoma. J Clin Oncol. 2015;33(29):3235.

D'Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C, Koch WM, Westra WH, Gillison ML. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007;356(19):1944-56.

Conway DI, Purkayastha M, Chestnutt IG. The changing epidemiology of oral cancer: definitions, trends, and risk factors. Br Dent J. 2018;225(9):867-73.

García-Martín JM, Varela-Centelles P, González M, Seoane-Romero JM, Seoane J, García-Pola MJ. Epidemiology of Oral Cancer. In: Panta P, ed. Oral Cancer Detection: Novel Strategies and Clinical Impact. Cham: Springer International Publishing. 2019;81-93.

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):359-86.

Liu F, Chen F, Huang J, Yan L, Liu F, Wu J, Qiu Y, Zheng X, Zhang R, Lin L, He B. Prospective study on factors affecting the prognosis of oral cancer in a Chinese population. Oncotarget. 2017;8(3):4352-9.

Osazuwa-Peters N, Massa ST, Christopher KM, Walker RJ, Varvares MA. Race and sex disparities in long-term survival of oral and oropharyngeal cancer in the United States. J Cancer Res Clin Oncol. 2016;142(2):521-8.

Noone AM, Cronin KA, Altekruse SF, Howlader N, Lewis DR, Petkov VI, Penberthy L. Cancer Incidence and Survival Trends by Subtype Using Data from the Surveillance Epidemiology and End Results Program, 1992-2013. Cancer Epidemiol Biomarkers Prev. 2017;26(4):632-41.

Jemal A, Ward E, Thun M. Declining death rates reflect progress against cancer. PloS One. 2010;5(3):e9584.

Howe HL, Wu X, Ries LA, Cokkinides V, Ahmed F, Jemal A, et al. Annual report to the nation on the status of cancer, 1975-2003, featuring cancer among U.S. Hispanic/Latino populations. Cancer. 2006;107(8):1711-42.

Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49(6):1374-403.

Van Monsjou H, Schaapveld M, Hamming-Vrieze O, De Boer J, Van Den Brekel M, Balm A. Cause-specific excess mortality in patients treated for cancer of the oral cavity and oropharynx: a population-based study. Oral Oncol. 2016;52:37-44.

Emerson MA, Banegas MP, Chawla N. Disparities in prostate, lung, breast, and colorectal cancer survival and comorbidity status among urban American Indians and Alaskan natives. Cancer Res. 2017;77(23):6770-6.

Olarte LS, Megwalu UC. The impact of demographic and socioeconomic factors on major salivary gland cancer survival. Otolaryngol Head Neck Surg. 2014;150(6):991-8.

Domínguez-Gordillo A, Esparza-Gómez G, García-Jiménez B, Cerero-Lapiedra R, Casado-Gómez I, Romero-Lastra P, Warnakulasuriya S. The pattern of lip cancer occurrence over the 1990-2011 period in public hospitals in Madrid, Spain. J Oral Pathol Med. 2016;45(3):202-10.

Maleki D, Ghojazadeh M, Mahmoudi SS, Mahmoudi SM, Pournaghi-Azar F, Torab A, Piri R, Azami-Aghdash S, Naghavi-Behzad M. Epidemiology of Oral Cancer in Iran: a Systematic Review. Asian Pac J Cancer Prev. 2015;16(13):5427-32.

Oliveira MLC, Wagner VP, Sant'ana M, Carrard VC, Hugo FN, Martins MD. A 10-year analysis of the oral squamous cell carcinoma profile in patients from public health centers in Uruguay. Braz Oral Res. 2015;29:1-8.

Bray F, Ferlay J, Laversanne M, Brewster DH, Gombe Mbalawa C, Kohler B, et al. Cancer Incidence in Five Continents: Inclusion criteria, highlights from Volume X and the global status of cancer registration. Int J Cancer. 2015;137(9):2060-71.

El-Qushayri AE, Dahy A, Reda A, Mahmoud MA, Mageed SA, Kamel AMA, Ghozy S. A closer look at the high burden of psychiatric disorders among healthcare workers in Egypt during the COVID-19 pandemic. Epidemiol Health. 2021;43:2021045.

Marx RE, Stern D. Oral and maxillofacial pathology: a rationale for diagnosis and treatment. Quintessence Publishing Company Hanover Park. 2012.

Siponen M, Neville BW, Damm DD, Allen CM. Multifocal lateral periodontal cysts: a report of 4 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2011;111(2):225-33.

Khammissa R, Meer S, Lemmer J, Feller L. Oral squamous cell carcinoma in a South African sample: Race/ethnicity, age, gender, and degree of histopathological differentiation. J Cancer Res Therap. 2014;10(4):908.

Dibas M, Doheim MF, Ghozy S, Ros MH, El-Helw GO, Reda A. Incidence and survival rates and trends of skull Base chondrosarcoma: A Population-Based study. Clin Neurol Neurosurg. 2020;198:106153.

Son PT, Reda A, Viet DC. Exchange transfusion in the management of critical pertussis in young infants: a case series. Vox Sang. 2021;116(9):976-82.

Nguyen TM, Huan VT, Reda A. Clinical features and outcomes of neonatal dengue at the Children's Hospital 1, Ho Chi Minh, Vietnam. J Clin Virol. 2021;138:104758.

Thieu H, Bach Dat B, Nam NH, Reda A, Duc NT, Alshareef A, Nguyen JG, Ngoc NM, Tien Huy N. Antibiotic resistance of Helicobacter pylori infection in a children's hospital in Vietnam: prevalence and associated factors. Minerva Med. 2020;111(5):498-501.