Lip and Oral Cavity Cancer Burden and Related Risk Factors in China: Estimates and Forecasts from 1990 to 2049

SIMPLE SUMMARY: China’s lip and oral cavity cancer burden is rising. The elderly have a relatively heavy disease burden, mainly due to poor oral health awareness, the side effects of other diseases and delayed treatment. Moreover, the incidence of the elderly over 50 years old is predicted to increase further from 2020 to 2049 in China. Males have a heavier disease burden, mainly due to their smoking, drinking and work exposure. Early screening and health intervention policies incorporating key populations and risk factors may deserve the consideration of policy makers to reduce the disease burden. ABSTRACT: Lip and oral cavity cancer is a common malignancy faced by many developing countries, and the disease burden is high in China. This study explored this cancer burden and its risk factors using data from China in the GBD 2019, along with predicting the incidence trends in 2020–2049. Data on age-standardized rates (ASR), incidence, death and disability-adjusted life years (DALY), by sex, age and risk factors were collected from the Institute for Health Metrics and Evaluation (IHME). Joinpoint regression and Age–Period–Cohort (APC) models were selected to analyze the epidemic trend of this cancer in China, and descriptive analysis was used for the time trend and age distribution of risk factors. The Bayesian APC model was selected to foresee the incidence trend in 2020–2049. This cancer burden was found to be in an upward trend in China in 1990–2019. The upward trend was more pronounced among men than among women. These cancer deaths and DALYs are overwhelmingly attributable to smoking and drinking. On APC analysis, the younger generation in China demonstrated a lower cancer risk. In 2049, the incidence of this cancer is projected to be 3.99/100,000, 6.07/100,000, 7.37/100,000, 10.49/100,000, 14.82/100,000, 19.19/100,000, 20.71/100,000, 23.64/100,000, 16.42/100,000 and 9.91/100,000 among those aged 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84, 85–89, 85–89 and over 95 years, respectively. Disease control policies and early screening should focus on men and the elderly and target different risk factors.