The burden of oral cancer in China, 1990–2017: an analysis for the Global Burden of Disease, Injuries, and Risk Factors Study 2017

BACKGROUND: Oral cancer is among the most common malignant tumors worldwide, and it has become an increasingly important public health problem in China. This study systematically assesses the current state of oral cancer in China from 1990 to 2017, providing new information and perspectives for oral health researchers and public health policy makers. METHODS: Based on the Global Burden of Disease, Injuries, and Risk Factors Study 2017 (GBD 2017), we evaluated the incidence rates, mortality and disability-adjusted life year (DALY) rates for oral cancer in China and their changing trends between 1990 and 2017, making comparisons by gender and age. We also assessed the DALY rates associated with oral cancer at the provincial level for 33 provinces and their trends over time. RESULTS: From 1990 to 2017, the number of new cases and the age-standardized incidence rate for oral cancer in China increased by 280.0% and 79.7%, respectively; the number of deaths and the age-standardized mortality rose by 196.8% and 29.0%, respectively; and the number of DALYs and the age-standardized DALY rate increased by 149.1% and 21.0%, respectively. The incidence rates for oral cancer rose after 30 years of age and peaked at 65–69 years; the mortality for oral cancer rose after 50 years of age and peaked at 65–69 years; and the DALY rates for oral cancer rose after 45 years of age and peaked at 65–69 years. The incidence rates, mortality and DALY rates for oral cancer in males were significantly higher than those in females and showed an upward trend, while there was a decrease or no significant change in females. The DALY rates increased in 21 provinces and decreased in 12 provinces, with the largest growth in Henan Province and the largest decline in Hong Kong Province. CONCLUSIONS: The burden of oral cancer in China continues to increase continuously. More prevention, control and intervention measures should be taken and increased attention paid to common risk factors is essential for the prevention of oral cancer.