title: The Health System and Policy Implications of Changing Epidemiology for Oral Cavity and Oropharyngeal Cancers in the United States From 1995 to 2016.
abstract: Oral cavity and oropharyngeal cancers are typically grouped under the general term, "oral cancer." Yet, the incidence of oropharyngeal cancers is increasing in the United States, while the incidence of oral cavity cancers has declined. These 2 distinct but conflated groups of oral cancers are attributed to different risk factors. Incidence and survival trends were examined across US population groups and by anatomical subsite. Disparities in incidence and survival by sex, race/ethnicity, and subsite were identified. Risk factors are complex, interactive, and not fully identified. Cancer control research illustrates health disparities in access to care and patient outcomes. Database and supplemental searches yielded 433 articles published between 1995 and 2016 characterizing aspects of oral cancer epidemiology relating to incidence, survival, risk, disparities, and cancer control. Oral cavity cancer survival in black men remains the most intractable burden. Although understanding of oral cancer etiology is improving, application to policy is limited. Cancer control efforts are diverse, sporadic, limited in scope, and generally lacking in success, and they need stratification by oral cavity cancers/oropharyngeal cancers. Further intervention and epidemiologic research, improved workforce capacity, and integrated care delivery are identified as important directions for public health policy. Sustained, multilevel campaigns modeled on tobacco control success are suggested.
authors.forename: Charles W
authors.initials: CW
authors.lastname: LeHew
authors.forename: Darien J
authors.initials: DJ
authors.lastname: Weatherspoon
authors.forename: Caryn E
authors.initials: CE
authors.lastname: Peterson
authors.forename: Abigail
authors.initials: A
authors.lastname: Goben
authors.forename: Karolina
authors.initials: K
authors.lastname: Reitmajer
authors.forename: Herve
authors.initials: H
authors.lastname: Sroussi
authors.forename: Linda M
authors.initials: LM
authors.lastname: Kaste
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000401:mortality; D005006:Ethnicity; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000401:mortality; D006291:Health Policy; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D015994:Incidence; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000401:mortality; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D030361:Papillomavirus Infections / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D000077195:Squamous Cell Carcinoma of Head and Neck; D014481:United States / Q000453:epidemiology
keywords: early detection of cancer; health-care disparities; incidence; mouth neoplasms; oropharyngeal neoplasms; risk behavior; survival; α-papillomavirus