Potential Years of Life Lost Due to Lip, Oral and Oropharyngeal Cancer in Brazil: Estimates and Forecasting.

INTRODUCTION

This study aims to evaluate the effects of age-period-cohort on potential years of life lost (PYLL) due to lip, oral, and oropharyngeal cancer (LOOPC) in Brazil from 1980 to 2024 and forecast PYLL for 2044.

METHODS

A retrospective ecological study was performed with all 5570 Brazilian municipalities. PYLL per 100,000 inhabitants and age-standardized-PYLL were calculated. Trends and the annual percent change (APC%) were assessed using the Prais-Winsten regression. Poisson regression was applied to assess age-period-cohort effects. Forecasts were conducted using the Lee-Carter model.

RESULTS

A total of 165,467 deaths resulting in 1,574,693 PYLL were observed. Lip cancer accounted for 0.9%, oral cancer for 60.4%, and oropharyngeal 38.7% of the total PYLL. Men accounted for 85.6% of the total PYLL due to LOOPC. The analysis of trends revealed that lip cancer in men shows a significant decreasing trend (β = -0.13, 95% CI [-0.22 to -0.05]), with an APC% = -2.71% (95% CI: -4.09% to -1.33%). The age-period-cohort model demonstrated superior fit compared to alternative models (p<0.001). Projections showed a decrease in lip cancer in men between 5-45 years and 50-60 years, while oral and oropharyngeal cancers are projected to increase before 25 years and decrease between 25 and 70 years for men. In contrast, oral cancer in women is projected to increase before 40 years and from 45 to 65 years.

CONCLUSION

Significant regional inequalities were observed in the PYLL projections. Although women have significantly less PYLL due to LOOPC, most projections show a reduction in PYLL for LOOPC in men and an increase in oral cancer in women.