Incidence and Mortality

Incidence and Mortality

In 1998, the estimated incidence of oral cancer in the United States was 9.3 cases per 100,000 persons, with a mortality rate of 2.5 per 100,000 persons.[1] It is estimated that there will be 35,310 new cases of oral cancer diagnosed in the United States in 2008 and 7,590 deaths due to this disease.[2] Oral cancer is more common in men than in women and accounts for 3% of new cancer cases in men and 2% in women.[2] Oral cancer can be divided into three clinicopathological categories: carcinoma of the lip vermillion, carcinoma of the oral cavity proper, and carcinoma of the oropharynx. Most patients with cancer of the oral cavity are males, although incidence of tongue cancer in U.S. females has progressively increased from 15% in the 1930s to 47% between 1988 and 1997.

Squamous cell carcinoma, which arises from the oral mucosal lining, accounts for more than 90% of the tumors in the oral cavity and oropharynx. Other types of primary tumors arising in this area include lymphoma, sarcoma, melanoma, and minor salivary gland tumors. In the Western world the most common locations of tumor development are the tongue and floor of the mouth; however, in parts of the world where tobacco or betel nut chewing is prominent, cancers of the retromolar trigone and buccal mucosa are common.

The most important factor affecting long-term outcome after treatment is the stage of disease at diagnosis, however, overall outcome is stage and site dependent. Although early stage tumors (without lymph node involvement) have an excellent anticipated cure rate (~75%–95%), the 5-year disease-free survival rate of oral squamous cell carcinoma has not improved considerably over the past 50 years, and is poor (about 20%–50%), depending on the stage of disease. Some or all of the differences in prognosis among disease stages may be due to lead-time bias rather than a benefit of early detection and treatment. Definitive treatment consists of either surgery or radiation therapy for early stage tumors of the oral cavity, and combined modality treatment with surgery and/or chemotherapy can be used to treat more advanced stages.

References

1. Ries LA, Eisner MP, Kosary CL, et al., eds.: SEER Cancer Statistics Review 1973-1998. Bethesda, Md: National Cancer Institute, 2001. Also available online. Last accessed July 30, 2008. 
   
   
2. American Cancer Society.: Cancer Facts and Figures 2008. Atlanta, Ga: American Cancer Society, 2008. Also available online. Last accessed October 1, 2008. 
   
   

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