Global Oral Health Inequalities in Incidence and Outcomes for Oral Cancer

TLDR

Oral cancer ranks among the top ten cancers worldwide, with incidence and five‑year survival rates varying widely, and is driven by lifestyle factors such as tobacco, areca nut, alcohol, poor diet, viral infections, and pollution, disproportionately affecting the poor and requiring coordinated national policies and a common risk factor approach to reduce inequalities. The study aims to reduce oral cancer inequalities by applying existing knowledge through a whole‑society approach and to pursue basic research on genetic determinants for targeted therapies.

Abstract

The mouth and oropharynx are among the ten most common sites affected by cancer worldwide, but global incidence varies widely. Five-year survival rates exceed 50% in only the best treatment centers. Causes are predominantly lifestyle-related: Tobacco, areca nut, alcohol, poor diet, viral infections, and pollution are all important etiological factors. Oral cancer is a disease of the poor and dispossessed, and reducing social inequalities requires national policies co-ordinated with wider health and social initiatives - the common risk factor approach: control of the environment; safe water; adequate food; public and professional education about early signs and symptoms; early diagnosis and intervention; evidence-based treatments appropriate to available resources; and thoughtful rehabilitation and palliative care. Reductions in inequalities, both within and between countries, are more likely to accrue from the application of existing knowledge in a whole-of-society approach. Basic research aimed at determining individual predisposition and acquired genetic determinants of carcinogenesis and tumor progression, thus allowing for targeted therapies, should be pursued opportunistically.