EpidemiologyEpidemiology of Oral of Oral CancerCancer

Module 1:Module 1:

Epidemiology of Cancer, U.S.

US Mortality, 2001US Mortality, 2001

Source: US Mortality Public Use Data Tape 2001, National Center for Health Statistics, Centers for Disease Control and Prevention, 2003.

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. Nephritis 39,480 1.6

10. Septicemia 32,238 1.3

Rank Cause of DeathNo. of deaths

% of all deaths

2004 Estimated US Cancer Cases*2004 Estimated US Cancer Cases*

*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder. American Cancer Society, 2004.

Men699,560

Women668,470 32% Breast

12% Lung & bronchus

11% Colon & rectum

6% Uterine corpus

4% Ovary

4% Non-Hodgkinlymphoma

4% Melanomaof skin

3% Thyroid

2% Pancreas

2% Urinary bladder

20% All Other Sites

Prostate 33%

Lung & bronchus 13%

Colon & rectum 11%

Urinary bladder 6%

Melanoma of skin 4%

Non-Hodgkin lymphoma4%

Kidney 3%

Oral Cavity 3%

Leukemia 3%

Pancreas 2%

All Other Sites 18%

Lifetime Probability of Developing Cancer, by Site, Men, US, 1998-2000

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

Site Risk

All sites 1 in 2

Prostate 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

Lifetime Probability of Developing Cancer, by Site, Women, US, 1998-2000

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

Site Risk

All sites 1 in 3

Breast 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

Estimated New Oral Cancer Cases Estimated New Oral Cancer Cases & Deaths by Sex, US, 2004*& Deaths by Sex, US, 2004*

Estimated New Cases Estimated Deaths

Both Sexes Male Female Both Sexes Males Females

All sites 1,368,030 699,560 668,470 563,700 290,890 272,810

Oral cavity/pharynx 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?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 cancerOropharyngeal 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:Oropharyngeal Cancers:Statistics for the United StatesStatistics 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 Cancer Survival*(%) by Site and Race,1992-1999and Race,1992-1999

*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.

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

Site White % DifferenceAfricanAmerican

13.1.2

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.

Incidence rates for oral and Incidence rates for oral and pharyngeal cancers (1992-1997) by pharyngeal cancers (1992-1997) by stage at diagnosis &race/ethnicitystage at diagnosis &race/ethnicity

13.1.3

* 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.

Incidence rates for oral and Incidence rates for oral and pharyngeal cancers (1992-1997) by pharyngeal cancers (1992-1997) by

stage at diagnosis and genderstage at diagnosis and gender

13.2.1

Data source: 1998 National Health Interview Survey, National Center for Health Statistics, Centers for Disease Control and Prevention.

Percentage of adults aged 40 and older Percentage of adults aged 40 and older who reported having had an oral cancer who reported having had an oral cancer

examination in the past yearexamination in the past year

13.3.1

* 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.

Oral and pharyngeal cancerOral and pharyngeal cancerdeaths (per 100,000*) in 1998 by deaths (per 100,000*) in 1998 by

race/ethnicity, gender and educationrace/ethnicity, gender and education

State of IllinoisState of Illinois

Statistics Statistics

Average Annual Age-adjusted Rates and DistributionsOral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite

All Races, Both Sexes, Illinois vs. National, 2000

Incidence Mortality

Illinois SEER† Illinois U.S.‡

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

Total 10.5 1,255 100.0 10.6 2,706 100.0 2.7 328 100.0 2.7 7,163 100.0

Stage at Diagnosis of Oral Cavity and Oropharyngeal Cancer IncidenceAverage Annual Percentages for 5-year Time Periods

All Races, Both Sexes, Illinois, 1986-2000

0%

10%

20%

30%

40%

50%

60%

1986-19901988-19921990-19941992-19961994-19981996-2000

Early StageLate Stage Unstaged

Source: Illinois Department of Public Health, Illinois State Cancer Registry, January 2003

Incidence & Mortality, Buccal Cavity Incidence & Mortality, Buccal Cavity and Pharynx, Both Sexes, 1986-2000and Pharynx, Both Sexes, 1986-2000

All Races Whites Blacks Asian/Other

Illinois Count Rate 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

State of Illinois

Illinois Department of Public Health, Illinois State Cancer Registry, January 2003

State of Illinois StatisticsState 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 StatisticsIllinois 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 PeriodsAll 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)

SummarySummary

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