Trends in oral cancer rates in the United States, 1973-1996

Objectives: To explore changes in demographic distribution, incidence and s urvival rates of oral cancer in the United States from 1973 through 1996. M ethods: From the Surveillance, Epidemiology, and End Results (SEER) data, w e computed the proportion of oral cancer by demographic characteristics, si te, and stage at diagnosis for 1973-84 and 1985-96. We estimated incidence and 5-year relative survival rates of oral cancer by age, gender, and race/ ethnicity, and compared survival rates between the two periods. The estimat ed annual percent change (EAPC) was used to explore trends in incidence rat e from 1973 through 1996. results: Most of the tongue and floor of mouth ca ncers (>54%) reported during 1973-84 and 1985-96 had spread to a distant si te at time of diagnosis. The age-adjusted annual incidence rates of oral ca ncer decreased among white men from 1973 through 1996, but increased among black men aged 65-69 years, and among young white men (aged 30-34 years) an d women (aged 25-29 years). These changes in trend were all statistically s ignificant (testing EAPC = 0 at the 0.05 level). Overall, there was no impr ovement in the 5-year relative survival rate of either whites or blacks wit h oral cancer. Conclusion: There was little change in early detection of or al cancer or in 5-year relative survival rates between 1973-84 and 1985-96 in nine SEER regions. This suggests a deficiency in professional and public education regarding early diagnosis of oral cancer. Furthermore, the incre asing trend of oral cancer among older black men and among younger whites m erits further investigation.