Oral Cancer Over Four Decades

Objectives: Oral cancer is defined as affecting the lips, tongue, buccal mucosa, floor of the mouth, and salivary glands. As some of these tumors are rare, epidemiological analysis is often inadequately described. Collecting data over almost four decades offers a unique opportunity to analyze rare and specific sites with significant case numbers. The aim of this study is to analyze distribution and trends of oral cancer, 1970-2006 among the Israeli population. Methods: Incidence and survival data were derived from the Israel National Cancer Registry and included all registered cases, 1970-2006. Results: Most prevalent cancer was Squamous Cell Carcinoma (SCC), with most cases among men above the age of 55 years. Females had higher levels of SCC in the lateral tongue, gums and buccal mucosa. Lymphoma and sarcoma were most prevalent among the youngest group. Tumors of salivary gland origin were the second most prevalent cancer in the palate, floor of mouth, tongue base and retromolar area. Buccal Cell Carcinoma (BCC) had highest survival rates, melanomas and metastatic disease the worst. Intra-orally best survival was for the lip, worse was the tongue base and gums. Over the time period, an increasing rate of tumors was found for the parotid gland vs. decreasing for the lips. Conclusions: Oral cancer presents a challenging disease for head and neck clinicians. In the current study 9,780 cases of oral cancer were registered in Israel between 1970 and 2006. It indicates that the age of above 55 years should be included as a risk marker. The high percentage of BCC is suggested to be due to the combination of sun exposure with a high proportion of fair skinned population. Highest cumulative 5-yr survival rate was for basal cell carcinoma, which is known to demonstrate a relatively good prognosis.