Trends and ethnic disparities in oral and oro-pharyngeal cancers in South Africa, 1992-2001

Abstract

Objective : To describe trends in the epidemiology of oral and of oro-pharyngeal (OAP) cancers in South Africa for the latest period available. Methods : Data were obtained from the South African pathology-based National Cancer Registry. All new cases of OAP cancers diagnosed and confirmed histologically from 1992 to 2001 are included for the ICD-10 sites C00 to C14, excluding those involving the major salivary glands (C07-C08) and the nasopharynx (C11). OAP cancer incidence is reported by demographics (gender, age, race/ethnicity) and the anatomical sites involved. The analysis on anatomical sites was restricted to squamous cell carcinomas. Results : Overall, males had a much higher OAP cancer incidence rate (world age-Standardised incidence rate [ASIR]= 7.01/100 000 per year) than females (ASIR=1.99). However, among Asian/Indian South Africans, OAP cancer incidence was higher among females (ASIR=4.60) than among males (ASIR=3.80). OAP cancer, excluding those involving the lip, was highest among Coloureds (ASIR=5.72) and lowest among Blacks (ASIR=3.16). OAP cancer incidence was stable overall, but incidence rates increased significantly among Coloured South Africans over the period under review (p=0.05). Cancer specifically involving the oro-pharyngeal was most common among Coloureds and showed an increasing trend during the period under review. Conclusions : Variations in the incidence of OAP cancers by gender, race/ethnicity and anatomic site indicate a need for culturally-targeted reductions in major risk factors, including promoting tobacco cessation and prevention of risky alcohol use. The implications of the role of the human papillomavirus (HPV) in the prevention of squamous cell carcinomas involving the oro-pharyngeal in South Africa require further investigation.