Epidemiology of lip and oral cancer according to the regions
We survey 339,913 new cases and 168,169 deaths of lip and oral cavity cancer in this study. The rank and percentage of lip and oral cavity cancer in all cancers of selected regions and cumulative risk are shown in Table 1. The incidence rates by regions are Africa (13,324), Asia (220,810), Europe (57,737), Latin America and the Caribbean (18,525), North America (25,354), and Oceania (4,163). The number of deaths by region are Africa (9,066), Asia (124,900), Europe (21,834), Latin America and the Caribbean (7,050), North America (4,424), and Oceania (895). Among all selected regions, Asia has the most cases and deaths as well as the highest percentage among all cancers. Conversely, Oceania has the fewest cases and deaths.
Table 1. Summary of the number, crude rank, ASR and MIR of lip and oral cancer by region.
|
New cases
|
Deaths
|
MIR
|
Region
|
Number
|
CR
|
ASR
|
Number
|
CR
|
ASR
|
Africa
|
13324
|
1.0
|
1.7
|
9066
|
0.7
|
1.2
|
0.71
|
Asia
|
220810
|
4.9
|
4.2
|
124900
|
2.8
|
2.4
|
0.57
|
Europe
|
57737
|
8.0
|
4.3
|
21834
|
3.0
|
1.6
|
0.38
|
Latin America and the Caribbean
|
18525
|
2.9
|
2.6
|
7050
|
1.1
|
1.0
|
0.38
|
North America
|
25354
|
7.1
|
4.2
|
4424
|
1.2
|
0.7
|
0.17
|
Oceania
|
4163
|
10.2
|
7.5
|
895
|
2.2
|
1.5
|
0.22
|
Epidemiology and parameters of the development and health expenditure of lip and oral cancer of the selected countries
The HDI, CHE, cancer incidence, cancer mortality, and MIR of selected countries are shown in Table 2. Norway has the highest HDI (0.954), and Egypt has the lowest HDI (0.700). The electronic GDP (e-GDP) ranges from 3.1% (Qatar) to 16.8% (United States of America). According to the incidence rates among all countries that were examined, Qatar and Bahrain have the lowest CR (1.0), and Chile has the lowest age standardized rate (ASR, 1.1), Latvia has the highest crude rates (12.7 of CR) and Australia has the highest ASR (6.9). Latvia has the highest mortality CR (6.0), and Egypt has the lowest mortality CR (0.4), while Latvia has the highest ASR (3.2) and Chile, Egypt, Israel, Malta and Jamaica have the lowest ASR (0.4). Australia has the lowest MIR (0.14), and Bahrain has the highest MIR (0.64).
Table 2. Summary of HDI, CHE, cancer incidence, cancer mortality, and MIR in lip and oral cancer (N=61).
|
HDI
|
CHE
|
Incidence
|
Mortality
|
|
Country
|
Per Capita
|
% of GDP
|
Number
|
CR
|
ASR
|
Number
|
CR
|
ASR
|
MIR
|
Argentina
|
0.830
|
998
|
6.8
|
1357
|
3.1
|
2.5
|
512
|
1.2
|
0.9
|
0.39
|
Australia
|
0.938
|
4934
|
9.4
|
2682
|
11.1
|
6.9
|
378
|
1.6
|
0.9
|
0.14
|
Austria
|
0.914
|
4536
|
10.3
|
488
|
5.7
|
3.0
|
232
|
2.7
|
1.4
|
0.47
|
Bahrain
|
0.838
|
1190
|
5.2
|
16
|
1.0
|
1.5
|
10
|
0.6
|
1.0
|
0.64
|
Belarus
|
0.817
|
352
|
6.1
|
653
|
7.0
|
4.1
|
316
|
3.4
|
2.0
|
0.49
|
Belgium
|
0.919
|
4228
|
10.5
|
923
|
8.3
|
4.7
|
305
|
2.7
|
1.4
|
0.33
|
Brazil
|
0.761
|
780
|
8.9
|
9902
|
4.7
|
4.0
|
3965
|
1.9
|
1.6
|
0.40
|
Bulgaria
|
0.816
|
572
|
8.2
|
459
|
6.7
|
3.4
|
164
|
2.4
|
1.2
|
0.36
|
Canada
|
0.922
|
4508
|
10.4
|
2633
|
7.3
|
3.9
|
594
|
1.6
|
0.8
|
0.22
|
Chile
|
0.847
|
1102
|
8.1
|
275
|
1.5
|
1.1
|
113
|
0.6
|
0.4
|
0.42
|
Colombia
|
0.761
|
374
|
6.2
|
775
|
1.6
|
1.4
|
308
|
0.6
|
0.5
|
0.39
|
Costa Rica
|
0.794
|
929
|
8.1
|
78
|
1.6
|
1.2
|
35
|
0.7
|
0.5
|
0.44
|
Croatia
|
0.837
|
852
|
7.4
|
291
|
7.2
|
3.8
|
117
|
2.9
|
1.5
|
0.40
|
Cuba
|
0.778
|
826
|
10.9
|
1238
|
11.0
|
6.2
|
380
|
3.4
|
1.8
|
0.31
|
Cyprus
|
0.873
|
1563
|
6.8
|
29
|
2.5
|
1.6
|
8
|
0.7
|
0.5
|
0.27
|
Czechia
|
0.891
|
1284
|
7.3
|
859
|
8.3
|
4.3
|
361
|
3.5
|
1.8
|
0.42
|
Denmark
|
0.930
|
5497
|
10.3
|
397
|
7.1
|
3.8
|
125
|
2.2
|
1.1
|
0.31
|
Ecuador
|
0.758
|
530
|
8.5
|
217
|
1.3
|
1.2
|
82
|
0.5
|
0.5
|
0.38
|
Egypt
|
0.700
|
157
|
4.2
|
1295
|
1.3
|
1.6
|
352
|
0.4
|
0.4
|
0.28
|
Estonia
|
0.882
|
1112
|
6.5
|
79
|
6.2
|
3.3
|
40
|
3.1
|
1.7
|
0.50
|
Fiji
|
0.724
|
175
|
3.6
|
27
|
3.0
|
2.9
|
11
|
1.2
|
1.2
|
0.40
|
Finland
|
0.925
|
4005
|
9.4
|
348
|
6.5
|
3.0
|
116
|
2.2
|
0.9
|
0.34
|
France
|
0.891
|
4026
|
11.1
|
6815
|
10.8
|
6.2
|
1516
|
2.4
|
1.3
|
0.22
|
Germany
|
0.939
|
4592
|
11.2
|
7271
|
9.1
|
4.4
|
2311
|
2.9
|
1.3
|
0.32
|
Iceland
|
0.938
|
4375
|
8.6
|
13
|
3.9
|
2.3
|
3
|
0.9
|
0.5
|
0.23
|
Ireland
|
0.942
|
4757
|
7.8
|
275
|
5.8
|
3.7
|
74
|
1.6
|
0.9
|
0.28
|
Israel
|
0.906
|
2756
|
7.4
|
155
|
1.9
|
1.4
|
51
|
0.6
|
0.4
|
0.32
|
Italy
|
0.883
|
2700
|
9.0
|
3500
|
6.1
|
2.7
|
1184
|
2.1
|
0.9
|
0.34
|
Jamaica
|
0.726
|
294
|
5.9
|
52
|
1.8
|
1.5
|
15
|
0.5
|
0.4
|
0.29
|
Japan
|
0.915
|
3733
|
10.9
|
8138
|
6.7
|
2.8
|
2496
|
2.1
|
0.7
|
0.31
|
Kuwait
|
0.808
|
1169
|
4.0
|
59
|
1.4
|
2.0
|
33
|
0.8
|
1.1
|
0.56
|
Latvia
|
0.854
|
784
|
5.8
|
239
|
12.7
|
6.8
|
113
|
6.0
|
3.2
|
0.47
|
Lithuania
|
0.869
|
923
|
6.5
|
188
|
6.7
|
3.7
|
114
|
4.1
|
2.3
|
0.61
|
Luxembourg
|
0.909
|
6236
|
6.0
|
45
|
7.8
|
4.8
|
10
|
1.7
|
1.0
|
0.22
|
Malaysia
|
0.804
|
386
|
4.0
|
640
|
2.0
|
2.0
|
302
|
1.0
|
1.0
|
0.48
|
Malta
|
0.885
|
2304
|
9.6
|
18
|
4.2
|
1.9
|
6
|
1.4
|
0.4
|
0.33
|
Mauritius
|
0.796
|
506
|
5.5
|
62
|
4.9
|
3.3
|
28
|
2.2
|
1.5
|
0.45
|
Netherlands
|
0.934
|
4746
|
10.7
|
1418
|
8.5
|
4.4
|
257
|
1.5
|
0.7
|
0.18
|
New Zealand
|
0.921
|
3554
|
9.3
|
264
|
5.7
|
3.4
|
58
|
1.2
|
0.7
|
0.21
|
Norway
|
0.954
|
7464
|
10.0
|
362
|
6.9
|
3.7
|
68
|
1.3
|
0.7
|
0.19
|
Oman
|
0.834
|
636
|
3.8
|
65
|
1.3
|
2.0
|
31
|
0.6
|
1.1
|
0.49
|
Philippines
|
0.712
|
127
|
4.4
|
1372
|
1.3
|
1.6
|
673
|
0.6
|
0.8
|
0.48
|
Poland
|
0.872
|
797
|
6.3
|
3203
|
8.6
|
4.8
|
1505
|
4.0
|
2.2
|
0.47
|
Portugal
|
0.850
|
1722
|
9.0
|
817
|
8.2
|
4.3
|
269
|
2.7
|
1.4
|
0.33
|
Qatar
|
0.848
|
2030
|
3.1
|
26
|
1.0
|
2.0
|
14
|
0.5
|
1.4
|
0.54
|
Russian Federation
|
0.824
|
524
|
5.6
|
9340
|
6.6
|
4.0
|
5443
|
3.8
|
2.3
|
0.58
|
Serbia
|
0.799
|
491
|
9.4
|
701
|
8.1
|
4.9
|
261
|
3.0
|
1.7
|
0.37
|
Singapore
|
0.935
|
2280
|
4.3
|
199
|
3.5
|
1.9
|
85
|
1.5
|
0.8
|
0.43
|
Slovakia
|
0.857
|
1108
|
6.9
|
541
|
10.1
|
6.0
|
224
|
4.2
|
2.5
|
0.42
|
Slovenia
|
0.902
|
1772
|
8.5
|
135
|
6.7
|
3.5
|
47
|
2.3
|
1.1
|
0.34
|
South Africa
|
0.705
|
471
|
8.2
|
1328
|
2.3
|
2.7
|
829
|
1.4
|
1.7
|
0.61
|
South Korea
|
0.906
|
2013
|
7.4
|
1467
|
2.9
|
1.6
|
507
|
1.0
|
0.5
|
0.34
|
Spain
|
0.893
|
2354
|
9.2
|
3843
|
8.6
|
4.0
|
969
|
2.2
|
1.0
|
0.26
|
Sweden
|
0.937
|
5600
|
11.0
|
556
|
5.7
|
2.8
|
145
|
1.5
|
0.7
|
0.26
|
Switzerland
|
0.946
|
9818
|
12.1
|
639
|
7.7
|
4.0
|
184
|
2.2
|
1.1
|
0.29
|
Thailand
|
0.765
|
217
|
3.8
|
4169
|
6.1
|
3.8
|
2159
|
3.2
|
2.0
|
0.52
|
Trinidad and Tobago
|
0.799
|
1146
|
6.0
|
42
|
3.1
|
2.2
|
20
|
1.5
|
1.1
|
0.48
|
Ukraine
|
0.750
|
125
|
6.1
|
3358
|
7.8
|
4.4
|
2058
|
4.7
|
2.8
|
0.60
|
United Kingdom
|
0.920
|
4356
|
9.9
|
5645
|
8.7
|
4.9
|
1443
|
2.2
|
1.1
|
0.25
|
United States of America
|
0.920
|
9536
|
16.8
|
22715
|
7.1
|
4.2
|
3830
|
1.2
|
0.7
|
0.17
|
Uruguay
|
0.808
|
1281
|
9.2
|
149
|
4.4
|
2.9
|
70
|
2.1
|
1.3
|
0.48
|
Association between MIR and parameters of the development and health expenditure of the selected countries
We further examined the association between the HDI, CHE and CRs of incidence and mortality (Fig 1). The association between HDI and CR of incidence (p<0.001, Figs 1A) yields significant results, while mortality (p=0.303, Figs 1B) does not yield significant results. On the other hand, the incidence of CHE to CR and CHE/GDP to CR show significant results (p=0.005, Figs 1C; p<0.001, Figs 1E, respectively), while the mortality of the CHE to the CR and the CHE/GDP to the CR do not yield significant results (p=0.997, Figs 1D; p=0.101, Figs 1F, respectively). In the correlation of MIRs, the results revealed a significant association for the HDI, CHE per capita, USD, and CHE/GDP with the MIR in lip and oral cancer (coefficient correlation: -0.597, p<0.001; coefficient correlation: -0.652, p<0.001; coefficient correlation: -0.651, p<0.001 respectively, Fig 2).