Analysis of lip and oral cavity cancer burden between China and the global from 1990 to 2021 and projections for the next fifteen years.

OBJECTIVE

This study aims to examine the temporal Trends in the burden of lip and oral cavity cancer in China from 1990 to 2021, stratified by age and sex. Key indicators-including prevalence, incidence, mortality, and disability-adjusted life years (DALYs)-are analyzed and compared with corresponding global metrics.

METHODS

Using data from the Global Burden of Disease (GBD) database spanning 1990 to 2021, we conducted a systematic analysis of trends in the burden of lip and oral cavity cancer in China and worldwide. The average annual percent change (AAPC) was estimated using Joinpoint regression analysis to quantify the magnitude of temporal trends. Differences in cancer burden across age groups and sexes were evaluated, and the ARIMA model was employed to project future trends. Finally, we conducted a decomposition analysis to determine the percentage contribution of factors affecting the burden of lip and oral cancer.

RESULTS

From 1990 to 2021, the age-standardized incidence rate (ASIR) of lip and oral cavity cancer in China increased from 1.704 to 2.681 per 100,000 population, while the global ASIR rose from 4.270 to 4.880 per 100,000. The age-standardized prevalence rate (ASPR) in China increased from 4.168 to 10.158 per 100,000, compared to a rise from 13.888 to 17.706 per 100,000 globally. The age-standardized mortality rate (ASMR) in China declined from 1.224 to 1.152 per 100,000, while the global ASMR decreased slightly from 2.454 to 2.424 per 100,000. The age-standardized disability-adjusted life years rate (ASDR) in China fell from 32.086 to 29.205 per 100,000, whereas the global ASDR decreased from 69.266 to 67.714 per 100,000. Between 1990 and 2021, the average annual percent changes (AAPCs) in China were 1.487% for ASIR, 2.899% for ASPR, - 0.187% for ASMR, and - 0.319% for ASDR. In comparison, the corresponding global AAPCs were 0.443%, 0.796%, - 0.029%, and - 0.072%, respectively. Age and sex had a significant impact on the burden of lip and oral cavity cancer, with males consistently exhibiting higher incidence, prevalence, mortality, and DALYs than females. Projections for the next 15 years indicate that the ASIR and ASMR in China will likely stabilize, while the ASPR and ASDR are expected to continue increasing. Globally, the ASMR and ASDR are projected to remain stable, whereas the ASIR and ASPR are anticipated to rise. The decomposition analyses revealed that both population aging and population increase factors exacerbated the burden of lip and oral cancer, whereas epidemiologic changes promoted the number of lip and oral cavity cancer cases but suppressed the increase in the number of deaths and DALYs.

CONCLUSION

From 1990 to 2021, the incidence and prevalence rates of lip and oral cavity cancer increased in both China and globally, while mortality and disability-adjusted life years (DALYs) experienced a slight decline. The burden of the disease was strongly associated with sex and age, with males exhibiting significantly higher incidence, prevalence, and mortality rates than females, and older adults demonstrating substantially higher rates compared to younger age groups. Over the next 15 years, the prevalence and DALY burden in China are projected to increase, while global incidence and prevalence are also expected to rise. Given China's rapidly aging population, these findings highlight growing public health challenges that call for sustained, coordinated efforts to mitigate the future burden.