The temporal and spatial epidemiology of lip cancer in England and Wales

Objective To examine trends in lip cancer mortality and incidence during th e 20(th) century, and its geographical distribution, in England and Wales a s a prerequisite to establishing any essential differences in the aetiology of lip and intra-oral cancer. Method Age-standardised rates for lip cancer mortality by gender from 1901 to 1991 were derived from archived OPCS data . Standardised incidence rates from 1962 to 1986 were also calculated. Regi strations of lip cancer between 1979 and 1983 in the 15 RHAs covering Engla nd and Wales were obtained from the same source and standardised incidence ratios (SIR) computed. Results Progressive and sustained falls in lip cance r mortality and incidence were recorded in the period covered. In males, th ese related particularly to cohorts born after 1856. In addition, the incid ence of lip cancer in both genders was found to be raised in a band stretch ing from East Anglia to the South West and also in the Trent and Wales RHAs . Conclusions The findings support an hypothesis that employment in the agr iculture, forestry and fishing industries, and also pipe smoking, were the major risk factors for lip cancer in the 20(th) century. Further research i s required to differentiate between the aetiological risk factors for lip a nd intra-oral cancer.