Abstract
BACKGROUND: Lip and oral cavity cancer (LOCC) constitutes a significant global health burden with substantial impact on cancer-related morbidity and mortality. Despite therapeutic advances and enhanced preventive strategies, marked disparities in LOCC outcomes persist across populations. This study aims to present a comprehensive temporal analysis utilizing the Global Burden of Disease Study (GBD) 2021, while providing projections through 2036 and examining the contributory effects of principal risk factors. METHODS: Leveraging GBD 2021 data, we analyzed temporal trends in LOCC incidence, deaths, and disability-adjusted life-years (DALYs) across global, regional, and national scales from 1990 to 2021. Future projections through 2036 were generated using the Bayesian Age-Period-Cohort (BAPC) model. We quantified the attributable burden associated with primary risk factors-smoking, alcohol use, and chewing tobacco-stratifying analyses by sex, geographical region, and socio-demographic index (SDI). RESULTS: Globally, 421,577 incident LOCC cases were documented in 2021, with South Asia demonstrating the highest burden (age-standardized rate [ASR], 9.8 per 100,000). Mortality increased by 113.9% since 1990, reaching 208,379 deaths in 2021. LOCC-associated DALYs totaled 5,874,070 years, with disproportionate impact on low and low-middle SDI regions. Risk factor attribution analysis revealed that 23.4%, 19.2%, and 18.7% of mortality was associated with smoking, alcohol use, and chewing tobacco, respectively. Projections indicate declining mortality trends but sustained increases in incidence and DALYs, particularly in females. CONCLUSIONS: These findings illuminate the escalating global burden of LOCC, with pronounced impact in low and low-middle SDI regions, particularly South Asia. The observed trends emphasize the imperative for implementing targeted prevention strategies, enhancing early detection programs, and establishing comprehensive policies addressing modifiable risk factors to mitigate the projected burden in high-risk populations.