Tobacco induced diseases · 2026
Global, regional, and national burden of lip and oral cavity cancer attributable to smoking, 1990-2021: A secondary dataset analysis of GBD 2021.
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Li Can, Tang Jincheng, Zhang Jingting, Tong Tianhao, Yang Renyi, Zeng Puhua
Аннотация
INTRODUCTION: Lip 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.
METHODS: In 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.
RESULTS: In 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).
CONCLUSIONS: While 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.
METHODS: In 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.
RESULTS: In 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).
CONCLUSIONS: While 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.