Evaluation of Nationwide Oral Mucosal Screening Program for Oral Cancer Mortality among Men in Taiwan

Current advances of oral cancer in Taiwan

OBJECTIVES

To provide updated statistics of oral cancer incidence and mortality in Taiwan, and to describe recent developments for oral cancer control to reduce oral cancer incidence and mortality.

METHODS

The Taiwan Cancer Registry Annual Report 2023, the Taiwan Cancer Registry Online Interactive Search System, and the 2023 Health Promotion Administration Annual Report are consulted and summarized. A literature search using PubMed was also conducted to identify Taiwan oral cancer control-related studies.

RESULTS

Taiwan, with a long history of areca/betel quid chewing, has battled with oral cancer for decades. In 2021, the male lip and oral cavity cancer incidence is 29.77 (per 100,000 persons) and mortality is 11.25. Over these years, the male chewing prevalence was reduced to 6.2% in 2018. Taiwan has a sustained national oral cancer screening programme provided to high-risk groups biennially.

CONCLUSIONS

Although the age-standardized incidence rates have been slowly decreasing since 2009, due to Taiwan's ageing population, the actual oral cancer burden is still stringent. The collaboration of multi-ministries and agencies on promoting areca nut and betel quid control, improving oral cancer awareness, and delivering cancer care remains essential to prevent oral cancer and reduce oral cancer deaths.

Morbidity and mortality of oral cancer in Taiwan: Trends from 2000 to 2021

Background/purpose

Oral cancer is a major cause of cancer morbidity and mortality worldwide, especially in Taiwan. This study investigated the morbidity and mortality of oral cancer in Taiwan from 2000 to 2021.

Materials and methods

The population data and the records of cancer registry were obtained from the websites of the Ministry of the Interior and the Ministry of Health and Welfare, respectively. The numbers of oral cancer cases and deaths were analyzed from 2000 to 2021.

Results

The numbers of oral cancer cases and deaths increased from 3378 to 1494 in 2000-8277 in 2020 and 3395 in 2021, respectively. The total increase of oral cancer cases was 4899 with a total increase rate of 145.03%, while the total increase of oral cancer deaths was 1901 with a total increase rate of 127.24%. The changes in the numbers of all cancer cases and deaths, as well as the morbidity and mortality of oral cancer or all cancers also showed similar trends. Furthermore, the death-to-case ratio of oral cancers decreased from 44.23% in 2000 to 40.84% in 2020. The total decrease was 3.39% with a total decrease rate of 7.66%.

Conclusion

In Taiwan, people's awareness of oral mucosal health is still inadequate. Obviously, there is still much room for improvement in the oral mucosal health education for our people. With the expertise and responsibility for taking good care of oral health of our people, the dental personnel should take active roles in the prevention and screening for oral cancers.

Epidemiology of Oral Cancer in Taiwan: A Population-Based Cancer Registry Study

Oral cancer (OC) is one of the most common cancers worldwide, and its incidence has regional differences. In this study, the cancer registry database obtained from 1980 to 2019 was used to analyze the characteristic of incidence of OC by average annual percentage change (AAPC) and an age–period–cohort model. Spearman’s correlation was used to analyze the relationship between the age-standard incidence rates (ASR) of OC and related risk factors. Our results showed that the ASR of OC increased from 4.19 to 27.19 per 100,000 population with an AAPC of 5.1% (95% CI = 3.9–6.3, p value < 0.001) in men and from 1.16 to 2.8 per 100,000 population with an AAPC of 3.1% (95% CI = 2.6–3.6, p value < 0.001) in women between 1980–1984 and 2015–2019. The age–period–cohort model reported a trend of rising then declining for the rate ratio in men, with peaks occurring in the 1975 cohort, with a rate ratio of 6.80. The trend of incidence of oral cancer was related to changes in the consumption of cigarettes and alcohol and production of betel quid, with r values of 0.952, 0.979 and 0.963, respectively (all p values < 0.001). We strongly suggest avoiding these risk factors in order to prevent OC.