Trends and disparities in the burden of oral cancer in Southeast Asia, 1990 to 2023: a retrospective analysis based on the Global Burden of Disease 2023 data

BACKGROUND: Oral cancer remains a major global public health issue, particularly in Southeast Asia, where its incidence and mortality rates are the highest worldwide. Malaysia, although a part of Southeast Asia, possesses a more advanced healthcare system, offering a unique comparison for understanding regional disparities. This study aimed to evaluate and compare the burden of oral cancer in Malaysia and Southeast Asia from 1990 to 2023 and forecast future trends using the most recent Global Burden of Disease (GBD) 2023 data. METHODS: Age-standardized incidence, mortality, and disability-adjusted life years (DALYs) were extracted from the GBD 2023 database. Joinpoint regression was applied to identify temporal shifts and estimate the annual percent change and average annual percent change. Autoregressive integrated moving average (ARIMA) models were used to predict future trends from 2024 to 2038. RESULTS: Malaysia has exhibited a largely stable burden of oral cancer over the past three decades, with DALYs increasing by only 2.3% and incidence by 18.0%. In contrast, Southeast Asia experienced substantial increases in DALYs (20.9%), incidence (38.8%), and mortality (14.9%). Marked sex disparities persisted, particularly in Southeast Asia, where males had 1.6× to 2.3× higher burden than females. ARIMA forecasts indicate that Malaysia's oral cancer burden will remain largely stable, whereas Southeast Asia is projected to experience significant increases through 2038. CONCLUSION: Malaysia's relatively stable trends may reflect stronger public health interventions, including tobacco control and improved access to care. In contrast, the continuously rising burden in Southeast Asia underscores the persistent gaps in prevention, early detection, and treatment.