Global and regional disparities in lip and oral cavity cancer mortality attributable to alcohol: An analysis of GBD 2021 study (1990–2021).

232 Background: Lip and oral cavity cancer, which is predominantly of the squamous cell type, is one of the most prevalent cancers of the head and and neck. In oral cavity cancers, the floor or anterior base of the mouth is routinely involved, meanwhile lip tumours are typically found in the lower lip. Majority of the cases are attributable to alcohol consumption and tobacco smoking and although it can be largely prevented through lifestyle modifications, it still poses a great threat due to lack of prompt detection and diagnosis; which is the biggest factor in survival and hence it is imperative to explore its trends and mortality rates. Methods: The Global Burden of Diseases (GBD) was used to extract data for deaths associated with lip and oral cavity cancer attributable to alcohol consumption from 1990-2021. Dataset was stratified globally, continent-wise and by socio-demographic index levels and USA was further stratified into its states. Age-standardized death rates (ASDRs), disability-adjusted life years (DALYs), and years of life lost (YLL) were assessed. Joinpoint regression was employed to quantify these estimates and calculate average annual percentage changes (AAPCs). Results: Globally, age standardized death rates (ASDR) had a slight declining trend for lip and oral cavity cancers from 1990-2021. In 1990, the ASDR was 0.49 (95% UI 0.38 to 0.59) which declined to 0.46 in 2021 (AAPC = -0.18; 95% CI -0.27 to -0.10). The disability-adjusted life-years (DALYs) were 14.73 in 1990 and dropped to 13.66 in 2021 (AAPC = -0.24; 95% CI -0.31 to -0.18). The age standardized years of life lost (YLL) showed consistent dropping trends during the same timeline (AAPC = -0.26; 95% CI -0.32 to -0.19). Europe and America reported the highest mortality rates in the continental analysis but both had declining trends [(AAPC = -0.93; 95% CI -1.15 to -0.71) and (AAPC = -0.72; 95% CI -0.86 to -0.59) respectively] while Asia showed the sharpest rise (AAPC = 1.17; 95% CI 1.06 to 1.29) and Africa had a slightly upward trend (AAPC = 0.21; 95% CI 0.16 to 0.25). During further analysis of USA we found that the states of District of Columbia, Connecticut and Massachusetts had the highest mortality rates with average ASDR 0.695, 0.464 and 0.461 respectively. An analysis of socio-demographic index levels revealed a progressive rise in mortality rates across low-middle, low and middle SDI regions, in that order, on the other hand high-middle and high SDI regions had negative trends. Conclusions: Globally efforts to minimise deaths from lip and oral cancers has been effective and there is a significant decline in the mortality. Nevertheless, regional imbalances still do exist. Further healthcare interventions, extensive research and preventive measures can contribute in alleviating this health risk.