In 2008, there were an estimated 263,900 new cases and 128,000 deaths as a result of oral cavity cancer worldwide. Major risk factors for this specific type of cancer includes smoking, alcohol use, smokeless tobacco products, and HPV infections. Studies have shown that synergistic effects are displayed by smoking and alcohol. The burden which occurs due to the contribution of these risk factors varies across regions. Smoking is responsible for 42% of deaths from cancers of the oral cavity (including pharynx) and heavy alcohol consumption for 16% of the deaths worldwide; the corresponding percentages in countries with high income are approximately 70% and 30% respectively (Ahmedin Jemal, et al., 2011).
Over the past decades, oral cavity cancer mortality rates amid males drastically declined in many countries, including those of Europe and Asia. However, the rates continued to rise in a number of Eastern European countries, such as Hungary and Slovakia. The rise in mortality noted among females in many European countries largely reflects the ongoing tobacco epidemic. This contrasts with the declining trends among all ages in both males and females in the United States and United Kingdom, where the tobacco epidemic originated and decreased earlier. Nonetheless, incidence rates for oral cancer sites in relation to HPV infections, such as the oropharynx, tonsil and base of the tongue, are escalating in young adults in the Unites States and in some European countries, which is hypothesized to be partially due to alterations in behavior regarding oral sex (Ahmedin Jemal, et al., 2011).
Mortality rates amid patients with major types of cancer, comprising lung, colon, and rectum, female breast, and prostate, have declined in the United States since the early 1990s due enhanced detection methods and treatment. The decline in mortality rates among patients between the ages of 25 and 64 were largely restricted to those with higher educational attainment. Death rates among patients with oral cavity and pharyngeal cancer have also declined over the past few decades in the United States. It has been confirmed that patterns in mortality rates for HPV-associated oral cavity and pharynx cancer differ by educational attainment. Reductions in mortality rates for cancers of the oral cavity and pharynx collectively were restricted to African Americans with a minimum of 12 years of education and Caucasians with more than 12 years of education. Patterns in oral cavity and pharynx mortality rates by educational attainment may also be affected by variations in risk factors and access to healthcare (Chen, DeSantis, & Jemal, 2011).
Smoking and alcohol are the two main known risk factors for developing oral cavity and pharynx cancers not related to HPV infection. The disproportion in reducing mortality rates from oral cavity and pharynx cancers not related to HPV by educational attainment may demonstrate variations in smoking trends. Developments in reducing the...