Module 1:
Epidemiology of Oral
Cancer
Epidemiology of Cancer, U.S.
US Mortality, 2001
Rank Cause of Death
No. of
deaths
% of all
deaths
1. Heart Diseases
700,142
29.0
2. Cancer
553,768
22.9
3. Cerebrovascular diseases
163,538
6.8
4. Chronic lower respiratory diseases
123,013
5.1
5. Accidents (Unintentional injuries)
101,537
4.2
6. Diabetes mellitus
71,372
3.0
7. Influenza and Pneumonia
62,034
2.6
8. Alzheimer’s disease
53,852
2.2
9.
39,480
1.6
32,238
1.3
Nephritis
10. Septicemia
Source: US Mortality Public Use Data Tape 2001, National Center for Health Statistics, Centers for Disease Control and Prevention,
2003.
2004 Estimated US Cancer Cases*
Prostate
33%
Lung & bronchus
Men
699,560
Women
668,470
32%
Breast
13%
12%
Lung & bronchus
Colon & rectum
11%
11%Colon & rectum
Urinary bladder
6%
6%
Uterine corpus
Melanoma of skin
4%
4%
Ovary
4%
Non-Hodgkin
lymphoma
4%
Melanoma
of skin
3%
Thyroid
2%
Pancreas
2%
Urinary bladder
20%
All Other Sites
Non-Hodgkin
lymphoma
4%
Kidney
3%
Oral Cavity
3%
Leukemia
3%
Pancreas
2%
All Other Sites
18%
*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder. American Cancer Society, 2004.
Lifetime Probability of Developing
Cancer, by Site, Men, US, 1998-2000
Site
Risk
All sites
Prostate
1 in 2
1 in 6
Lung & bronchus
1 in 13
Colon & rectum
1 in 17
Urinary bladder
1 in 29
Non-Hodgkin lymphoma
1 in 48
Melanoma
1 in 55
Kidney
1 in 69
Leukemia
1 in 70
Oral cavity
1 in 72
Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 5.1 Statistical Research and Applications
Branch, NCI, 2003. http://srab.cancer.gov/devcan
Lifetime Probability of Developing Cancer,
by Site, Women, US, 1998-2000
Site
All sites
Breast
Risk
1 in 3
1 in 7
Lung & bronchus
1 in 17
Colon & rectum
1 in 18
Uterine corpus
1 in 38
Non-Hodgkin lymphoma
1 in 57
Ovary
1 in 59
Pancreas
1 in 83
Melanoma
1 in 82
Urinary bladder
1 in 91
Uterine cervix
1 in 128
Source:DevCan: Probability of Developing or Dying of Cancer Software, Version 5.1 Statistical Research and Applications
Branch, NCI, 2003. http://srab.cancer.gov/devcan
Estimated New Oral Cancer Cases
& Deaths by Sex, US, 2004*
Estimated New Cases
Both Sexes
All sites
Oral cavity/pharynx
Male
Female
1,368,030 699,560 668,470
Estimated Deaths
Both Sexes
563,700
Males
Females
290,890 272,810
28,260
18,550
9,710
7,230
4,830
2,400
Tongue
7,320
4,860
2,460
1,700
1,100
600
Mouth
10,080
5,410
4,670
1,890
1,070
820
Pharynx
8,250
6,330
1,920
2,070
1,460
610
Other oral cavity
2,610
1,950
660
1,570
1,200
370
What is oral cancer?
 Cancer that starts in the mouth is oral
cavity cancer
– Includes lips
– Inside lining of cheeks (buccal mucosa)
– Gingiva (gums)
– Floor of the mouth
– Anterior 2/3rds of the tongue
– Hard palate
Oropharyngeal cancer
 Refers to cancers that start in the
oropharynx (posterior to the oral cavity)
 For convenience, these modules will refer
to oral cavity and oropharyngeal cancers
as “oral cancer”
Oropharyngeal Cancers:
Statistics for the United States
 The American Cancer Society
estimates 29,370 new cases of oral
cavity and oropharyngeal cancer in
2005
 About 7,320 will die from the disease
during 2005
Cancer Survival*(%) by Site
and Race,1992-1999
Site
White
African
American
% Difference
All Sites
64
53
11
Breast (female)
88
74
14
Colon & rectum
63
53
10
Leukemia
48
39
9
Non-Hodgkin lymphoma
57
47
10
Oral cavity
60
36
24
Prostate
99
93
6
Urinary bladder
83
64
19
Uterine cervix
73
61
12
*5-year relative survival rates based on cancer patients diagnosed from 1992 to 1999 and followed through 2000. Source:
Surveillance, Epidemiology, and End Results Program, 1975-2000, Division of Cancer Control and Population Sciences, National
Cancer Institute, 2003.
Incidence rates for oral and
pharyngeal cancers (1992-1997) by
stage at diagnosis &race/ethnicity
The totals in this figure include unstaged cancers.
Data source: Surveillance, Epidemiology, and End Results (SEER) 11 Registries Public-Use, August 1999 Submission
(1992-1997). The rates are per 100,000 and are age-adjusted to the 1970 U.S. standard population.
13.1.2
Incidence rates for oral and
pharyngeal cancers (1992-1997) by
stage at diagnosis and gender
* The totals in this figure include the unstaged cancers.
Data source: Surveillance, Epidemiology, and End Results (SEER) 9 Registries Public-Use, August 1999 Submission
(1993-1997). The rates are per 100,000 and are age-adjusted to the 1970 U.S. standard population.
13.1.3
Percentage of adults aged 40 and older
who reported having had an oral
cancer examination in the past year
Data source: 1998 National Health Interview Survey, National Center for Health Statistics, Centers for Disease
Control and Prevention.
13.2.1
Oral and pharyngeal cancer
deaths (per 100,000*) in 1998 by
race/ethnicity, gender and education
* Age adjusted to the year 2000 U.S. standard population.
Data source: 1998 National Vital Statistics System, National Center for Health Statistics, Centers for Disease
Control and Prevention.
13.3.1
State of Illinois
Statistics
Average Annual Age-adjusted Rates and Distributions
Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite
All Races, Both Sexes, Illinois vs. National, 2000
Incidence
Mortality
SEER†
Illinois
U.S.‡
Illinois
Site
Rate
Count
%
Rate
Count
%
Rate
Count
%
Rate
Count
%
Lip
0.6
76
6.1
0.9
220
8.1
0.0
4
1.2
0.0
63
0.9
Tongue
2.5
294
23.4
2.6
663
24.5
0.7
80
24.4
0.6
1,687
23.6
Salivary Gland
1.1
132
10.5
1.3
344
12.7
0.2
27
8.2
0.2
636
8.9
Floor of Mouth
1.0
123
9.8
0.7
185
6.8
0.1
10
3.0
0.1
143
2.0
Gum/Other
Mouth
1.6
192
15.3
1.8
445
16.4
0.5
57
17.4
0.4
1,156
16.1
Nasopharynx
0.6
77
6.1
0.7
169
6.2
0.2
22
6.7
0.2
628
8.8
Tonsil
1.3
154
12.3
1.3
337
12.5
0.2
25
7.6
0.2
493
6.9
Oropharynx
0.4
52
4.1
0.3
79
2.9
0.2
25
7.6
0.2
521
7.3
Hypopharynx
0.9
108
8.6
0.8
204
7.5
0.1
11
3.4
0.1
348
4.9
Other
Oral Cavity
0.4
47
3.7
0.2
60
2.2
0.6
67
20.4
0.6
1,488
20.8
10.5
1,255
100.0
10.6
2,706
100.0
2.7
328
100.0
2.7
7,163
100.0
Total
Stage at Diagnosis of Oral Cavity and Oropharyngeal Cancer Incidence
Average Annual Percentages for 5-year Time Periods
All Races, Both Sexes, Illinois, 1986-2000
60%
50%
40%
30%
20%
10%
0%
1986-1990
1988-1992
1990-1994
1992-1996
1994-1998
1996-2000
Early StageLate Stage Unstaged
Source: Illinois Department of Public Health, Illinois State Cancer Registry, January 2003
Incidence & Mortality, Buccal Cavity
and Pharynx, Both Sexes, 1986-2000
State of Illinois
All Races
Illinois
Count Rate
Whites
Blacks
Asian/Other
Count
Rate
Count
Rate
Count
Rate
Incidence
18,201
10.9
14,693
10.1
3,014
14.9
307
8.2
Mortality
5,504
3.3
4,284
2.9
1,153
5.8
67
1.7
Illinois Department of Public Health, Illinois State
Cancer Registry, January 2003
State of Illinois Statistics
Incidence Rate for Oral Cancer,
1993-1997
Illinois
US
Women
Men
Women
Men
5.3
14.4
5.9
15.3
American Cancer Society, 2004
Illinois Statistics
Mortality Rate for Oral Cancer,
1993-1997
Illinois
US
Women
Men
Women
Men
1.3
4.3
1.4
3.8
American Cancer Society, 2004
Stage at Diagnosis of Oral Cavity and
Oropharyngeal Cancer Incidence
§
Average Annual Percentages for 5-year Time Periods
All Races, Both Sexes, Illinois, 1986-2000
Figure 11 Oral Cavity and Oropharyngeal Cancer Incidences, 1986-2000 (Site-Race-Ethnicity)
Includes only invasive cancers. Hispanics/non-Hispanics are not mutually exclusive from whites, blacks and
Asian/other races.Source: Illinois Department of Public Health, Illinois State Cancer Registry, January 2003
Oral Cavity and Oropharynx Average Annual Age-adjusted Cancer Rates by Gender and
Race/Ethnicity in Illinois, Incidence§ and Mortality, 1996-2000
Percentage Cases Diagnosed at Early Stage Oral Cavity and
Oropharyngeal Cancer Incidence§ Illinois Counties, 1986-2000
Figure 14 Oral Cavity and Oropharyngeal Cancer Incidence in Illinois Counties (1986-2000)
Summary
 Oropharyngeal cancers are prevalent
throughout the U.S. and in the State of
Illinois
 Men face a greater risk than women, with
African American men facing the greatest
risk