ORAL CAVITY

following subsites: lip (excluding skin of the lip), tongue,salivary glands, gum, mouth, pharynx,oropharynx, and hypopharynx. Cancer of the nasopharynx is treated separately in this publication, since its epidemiologic patterns are distinct from the others in this group.

C

ancer of the oral cavity includes the

For the SEER areas, incidence rates for oral cavity cancer are two to four times higher among men than women for all racial/ethnic groups except Filipinos, among whom the rates for the two sexes are similar. Too few cases occurred among Alaska Natives, American Indians, Koreans, and Vietnamese women for the calculation of reliable rates. Across racial/ethnic groups, the incidence rates vary by a factor of four in men and about three in women. Among men, the highest rates are in blacks, followed by whites (especially non-Hispanic whites), Vietnamese, and native Hawaiians. Less variation occurs in women, among whom high rates occur in non-Hispanic whites, blacks and Filipinos. Although reasons for these racial/ethnic and sex differences have not been established, differences in the extent of exposure to risk factors for oral cavity cancer (see below) are presumably largely responsible. Incidence rates for oral cavity cancer increase with age in all groups except the oldest age group of black men and women. The greatest increase in rates occurs between the 30-54 year old group and the 55-69 year old group. For several racial/ethnic and sex groups, the numbers of cases were too few to compute reliable rates by age category. Mortality rates for oral cavity cancer are substantially lower than incidence rates, reflecting the reasonably high survival rates for this cancer site. The mortality rates
National Cancer Institute
96

increase with age in all groups except black men and women aged 70 years and older. Tobacco use, including pipes, cigars, cigarettes, and chewing tobacco are wellestablished causes of cancers of the oral cavity. Chewing of betel nut, not a common practice in the United States but a widespread habit in some parts of the world, is also a known cause. Alcohol consumption, especially when combined with cigarette smoking, is an established risk factor. Both factors together interact synergistically. Finally, some evidence suggests that diets high in fruits and vegetables reduce the risk of developing this cancer.

SEER Program

3 * 8. * National Cancer Institute 97 SEER Program .ORAL CAVITY (excluding Nasopharynx) SEER INCIDENCE Rates.9 5 10 15 20 25 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 0.9 5.6 14. 1988-1992 MEN ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) BLACK CHINESE FILIPINO HAWAIIAN JAPANESE KOREAN VIETNAMESE WHITE 7.4 2. N/A = information not available.7 1.7 SEER Program National Cancer Institute 9. = rate not calculated when fewer than 25 cases. age-adjusted to 1970 U.4 11. standard.S.6 VIETNAMESE WHITE * * * * 2.4 5.0 WOMEN ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) 20.7 6.8 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 5 HISPANIC (TOTAL) WHITE HISPANIC 15. 1988-1992 MEN ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) BLACK CHINESE FILIPINO HAWAIIAN JAPANESE WOMEN ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) 8.3 * 2.1 JAPANESE 0.3 5.5 5 10 15 20 25 NOTE: Rates are "average annual" per 100.8 5.1 0.8 KOREAN N/A VIETNAMESE N/A WHITE 3.3 * * * 3.7 0.5 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 2.7 BLACK CHINESE FILIPINO HAWAIIAN JAPANESE KOREAN 11.1 WHITE NON-HISPANIC 20 25 0 2.000 population.7 2.7 1.1 5 10 15 20 25 10 15 United States MORTALITY Rates.2 * * * 2.7 BLACK CHINESE FILIPINO HAWAIIAN * * 1.8 KOREAN N/A VIETNAMESE N/A WHITE 1.6 1.3 5.7 3.

6 41. * SEER Program .6 55.5 30.4 51.ORAL CAVITY (excluding Nasopharynx) SEER INCIDENCE Rates by Age at Diagnosis. 1988-1992 MEN ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) BLACK CHINESE FILIPINO HAWAIIAN JAPANESE KOREAN VIETNAMESE WHITE WOMEN ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) * * 4.4 30 60 90 NOTE: Rates are per 100.5 HAWAIIAN JAPANESE KOREAN VIETNAMESE 22.7 36.6 WHITE 29.3 AMERICAN INDIAN SEER Program (NEW MEXICO) BLACK CHINESE FILIPINO 21.2 * * * AGE 70+ 33.1 53.6 24.5 * * * * * AGE 30-54 HAWAIIAN JAPANESE KOREAN VIETNAMESE 11.1 30 60 90 * * 35.0 HAWAIIAN JAPANESE KOREAN VIETNAMESE 10.4 6.1 15.5 71. age-adjusted to 1970 U.8 6.7 22.5 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) BLACK CHINESE FILIPINO HAWAIIAN JAPANESE KOREAN VIETNAMESE WHITE 28.9 AGE 55-69 27.2 BLACK CHINESE FILIPINO 6.6 2.9 30 60 90 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) 56.7 77.6 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 30 53.6 * * * * * * * * * * 13.0 BLACK CHINESE FILIPINO * * * * * * * * 6.5 WHITE 4.0 * * * * * * 15. standard.000 population.1 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) BLACK CHINESE FILIPINO HAWAIIAN JAPANESE KOREAN VIETNAMESE WHITE 6.6 60 90 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 15. National Cancer Institute 98 * = rate not calculated when fewer than 25 cases.7 12.4 72.3 30 60 90 * * 12.7 4.2 30.8 WHITE 20.S.2 30 60 90 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 ALASKA NATIVE National Cancer Institute 2.

3 * * * * * * 7.4 30 60 90 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 6. standard. age-adjusted to 1970 U.000 population.1 30 60 90 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 ALASKA NATIVE National Cancer Institute 0.0 6. National Cancer Institute 99 SEER Program .4 WHITE HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 19. * = fewer than 25 deaths.0 KOREAN N/A VIETNAMESE N/A WHITE 0.9 30 60 90 * * * * * * * * * * * AGE 70+ HAWAIIAN JAPANESE KOREAN VIETNAMESE N/A N/A 23.2 0.9 1.6 30 60 90 NOTE: Rates are "average annual" per 100.6 WHITE HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) BLACK CHINESE FILIPINO HAWAIIAN JAPANESE KOREAN VIETNAMESE WHITE 8.9 23.9 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) BLACK CHINESE FILIPINO HAWAIIAN JAPANESE KOREAN VIETNAMESE WHITE 1.3 2.9 N/A N/A 10.3 BLACK CHINESE FILIPINO * * * * AGE 30-54 HAWAIIAN JAPANESE N/A N/A 2.1 10.8 33.3 1.6 * * * * * * 1. 1988-1992 MEN ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) BLACK CHINESE FILIPINO HAWAIIAN JAPANESE KOREAN VIETNAMESE WHITE WOMEN ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) * * 9. N/A = data unavailable.7 30 60 90 * * * * * * AMERICAN INDIAN SEER Program (NEW MEXICO) BLACK CHINESE FILIPINO 7.8 * 13.9 30 60 90 HISPANIC (TOTAL) WHITE HISPANIC WHITE NON-HISPANIC 0 ALASKA NATIVE AMERICAN INDIAN (NEW MEXICO) 28.2 19.S.3 BLACK CHINESE FILIPINO 1.6 13.3 8.ORAL CAVITY (excluding Nasopharynx) United States MORTALITY Rates by Age at Death.2 0.7 AGE 55-69 HAWAIIAN JAPANESE KOREAN VIETNAMESE * * * * * * N/A N/A N/A N/A 4.9 4.

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