Cancer of the oral cavity
includes the following subsites: lip (excluding skin of the lip), tongue, salivary
glands, gum, mouth, pharynx, oropharynx, and hypopharynx. Cancer of the nasopharynx
is treated separately in this publication, since its epidemiologic patterns
are distinct from the others in this group.
For the SEER areas, incidence
rates for oral cavity cancer are two to four times higher among men than women
for all racial/ethnic groups except Filipinos, among whom the rates for the
two sexes are similar. Too few cases occurred among Alaska Natives, American
Indians, Koreans, and Vietnamese women for the calculation of reliable rates.
Across racial/ethnic groups, the incidence rates vary by a factor of four in
men and about three in women. Among men, the highest rates are in blacks, followed
by whites (especially non-Hispanic whites), Vietnamese, and native Hawaiians.
Less variation occurs in women, among whom high rates occur in non-Hispanic
whites, blacks and Filipinos. Although reasons for these racial/ethnic and sex
differences have not been established, differences in the extent of exposure
to risk factors for oral cavity cancer (see below) are presumably largely responsible.
Incidence rates for oral
cavity cancer increase with age in all groups except the oldest age group of
black men and women. The greatest increase in rates occurs between the 30-54
year old group and the 55-69 year old group. For several racial/ethnic and sex
groups, the numbers of cases were too few to compute reliable rates by age category.
Mortality rates for oral
cavity cancer are substantially lower than incidence rates, reflecting the reasonably
high survival rates for this cancer site. The mortality rates increase with
age in all groups except black men and women aged 70 years and older.
Tobacco use, including
pipes, cigars, cigarettes, and chewing tobacco, are well-established causes
of cancers of the oral cavity. Chewing of betel nut, not a common practice in
the United States but a widespread habit in some parts of the world, is also
a known cause. Alcohol consumption, especially when combined with cigarette
smoking, is an established risk factor. Both factors together interact synergistically.
Finally, some evidence suggests that diets high in fruits and vegetables reduce
the risk of developing this cancer.
Source: Miller BA,
Kolonel LN, Bernstein L, Young, Jr. JL, Swanson GM, West D, Key CR, Liff JM,
Glover CS, Alexander GA, et al. (eds). Racial/Ethnic Patterns of Cancer in the
United States 1988-1992, National Cancer Institute. NIH Pub. No. 96-4104. Bethesda,
MD, 1996.
Graphs showing incidence
and mortality for specific racial and ethnic groups including information
that may not be discussed in the text above, is available at the NCI's
Surveillance, Epidemiology, and End Results (SEER) Web site at: http://seer.cancer.gov/.
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