Incidence trends and projections of lip and oral cavity cancer in China 1990-2021: an age-period-cohort and decomposition analysis.

Abstract

Objective: To investigate the historical trends, underlying causes, and future projections of lip and oral cavity cancer (LOCC) incidence in China.

Methods: Annual cases and age-standardized incidence rates (ASIR) for LOCC in China from 1990 to 2021 were extracted from the Global Burden of Disease (GBD) 2021 study. Age-Period-Cohort (APC) models were employed to assess the effects of age, period, and cohort. Bayesian APC models were applied to project future incidence trends, and decomposition analysis was conducted to identify factors influencing incidence.

Result: From 1990 to 2021, the cases and ASIR of LOCC increased substantially in male and slightly in female. The ASIR and number of cases in male were higher than that in female during the study period. The APC model showed that the net drift of ASIR in males and females during the study period was 2.34% (95% confidence interval [CI]: 2.10% to 2.59%) and 0.26% (95% CI: 0.13 to 0.39), respectively. LOCC incidence increased the fastest among males and females aged 25-29 years. The incidence of LOCC in male and female increased with age, reaching its peak in the age group of 90-94 years (73.35/100,000 and 11.14/ 100,000, respectively). The period effect showed an increasing trend, while the birth cohort effect showed a decreasing trend. Predictions show that the incidence and cases of LOCC will continue to rise. Population growth, ageing and epidemiological factors in both male and female contributed to the rise of LOCC cases, except for a decrease in the period 1997-2013 due to changing epidemiological factors in female.

Conclusion: The increasing trend of LOCC in China is closely related to age, period and cohort. Future projections emphasize the need for targeted prevention focusing on high-risk groups and modifiable factors.