The Evolving Epidemiology of Lip and Oral Cavity Cancers in Central Asia: A Global Burden of Disease Study Analysis (1990-2019) - A Cross-Sectional Study.

BACKGROUND AND AIMS: Globally, geographic variation in lip and oral cavity cancer (LOCC) is significant, with high burdens in South Asia. We aimed to quantify the burden, trends, and risk factors of LOCC in the neighboring, yet epidemiologically distinct, Central Asian region.

METHODS: Using data from the Global Burden of Disease 2019 study, we extracted age-standardized incidence, mortality, and Disability-Adjusted Life Year (DALY) rates of LOCC for Central Asian countries. We analyzed trends using joinpoint regression to compute Average Annual Percentage Change (AAPC) and assessed the association with the Socio-demographic Index (SDI). The burden attributable to smoking, alcohol use, and chewing tobacco was quantified.

RESULTS: In 2019, the all-age LOCC incidence in Central Asia was 2.41 per 100,000, substantially lower than the global rate of 4.88. However, the intra-regional range was wide (0.86 in Tajikistan to 3.57 in Georgia). From 1990 to 2019, the regional mortality rate declined significantly (AAPC: -0.17%), yet national trends diverged, with notable increases in Georgia (AAPC: 0.47%), Armenia (0.13%), and Uzbekistan (0.13%). A positive correlation was observed between SDI and incidence (r = 0.58, p = 0.08). The fraction of DALYs attributable to the three key risk factors rose to 59.75% in 2019 (from 54.32% in 1990), with alcohol being the predominant contributor (35.86%).

CONCLUSION: Despite a lower overall burden than global estimates, LOCC presents a serious and growing public health challenge in parts of Central Asia, characterized by sharp disparities and increasing attribution to alcohol and tobacco. These findings highlight the urgent need for policy attention and tailored prevention in this understudied region.