ArticleTobacco induced diseases2026
Global, regional, and national burden of lip and oral cavity cancer attributable to smoking, 1990-2021: A secondary dataset analysis of GBD 2021.
Article in Tobacco induced diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionLip and oral cavity cancer (LOCC) poses a major public health challenge, primarily driven by smoking. This study evaluates the spatiotemporal trends of smoking-attributable LOCC using Global Burden of Disease (GBD) 2021 data, focusing on regional disparities and age-specific stagnations.
methodsIn this secondary dataset analysis of GBD 2021, incidence, mortality, and disability-adjusted life years of smoking-attributable LOCC across 204 countries and territories (1990-2021) were analyzed. Trends were quantified using estimated and average annual percentage changes (EAPC/AAPC) by region, gender, age, and sociodemographic index.
resultsIn 2021, smoking accounted for 23.41% (95% UI: 20.1-26.5) of global LOCC deaths. Although the global age-standardized mortality rate (ASMR) decreased from 0.77 in 1990 to 0.56 per 100000 population in 2021 (EAPC= -1.09; 95% CI: -1.13 - -1.05), absolute deaths increased by 59.48% to 48773 (95% UI: 33622-63367). Notably, East Asia (EAPC=0.46; 95% CI: 0.19-0.64) and Central Sub-Saharan Africa (EAPC=0.12; 95% CI: 0.04-0.23) uniquely showed increasing ASMRs. Age-specific analysis revealed a plateaued improvement in the elderly, particularly the 75-79 years group (AAPC= -0.1; 95% CI: -0.5-0.3), contrasting with declines in younger groups. Males bore a higher burden, though female mortality declined faster (EAPC= -1.40 vs -1.10).
conclusionsWhile the global smoking-attributable LOCC burden is reducing, there are widening regional disparities and a statistical stagnation, specifically in the age group of 75-79 years. These divergent trends generate important hypotheses regarding the limits of uniform prevention. Persistent burdens imply context-specific factors, such as potential gene-environment interactions in East Asia and poly-tobacco use in South Asia, which warrant further investigation to achieve more equitable reductions in disease burden.
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