Abstract
OBJECTIVE: To evaluate global trends and disparities in the quality of care for lip and oral cavity cancer (LOCC) from 1990 to 2021 using the Quality of Care Index (QCI). METHODS: Data on LOCC burden were obtained from the Global Burden of Disease (GBD) 2021 study, covering 204 countries and territories from 1990 to 2021. The QCI was constructed via principal component analysis of four component indices: mortality-to-incidence ratio, prevalence-to-incidence ratio, years of life lost to years lived with disability ratio, and disability-adjusted life years to prevalence ratio. Analyses were stratified by socio-demographic index (SDI), age, and sex. RESULTS: A geographical decoupling was observed: high-SDI regions had the highest LOCC incidence, while low-middle SDI regions had the highest mortality. The global QCI improved from 1990 to 2021 but strongly correlated with national development. Females consistently had higher QCI scores than males across all SDI groups. The QCI-age relationship varied by SDI region. CONCLUSIONS: Despite global improvement, significant inequities in LOCC care quality persist across regions, ages, and sexes. Future strategies must focus on enhancing healthcare system performance and ensuring equitable access to effective care.