Epidemiology of oral cavity cancer in women: Identifying the highest-risk age group.

Abstract

e22594 Background: Oral cavity cancer has historically been more prevalent in men, largely attributed to tobacco use, alcohol consumption, and human papillomavirus (HPV). Emerging data however, suggest shifting patterns and a rising disease burden among women. This study aims to identify the female age groups most at risk for malignancy. Methods: We conducted a retrospective, population-based analysis using data from the Surveillance, Epidemiology, and End Results (SEER) Program, Registry 17, which captures approximately 48% of the U.S. population and includes information on patient demographics and tumor characteristics of various malignancies. In our analysis, female patients diagnosed with oral cavity cancer between 2000 and 2022 were included. Cases were stratified by age group, and age-adjusted incidence rates were calculated for each group using SEER*Stat software for two time periods: 2000–2010 and 2011–2022. Trends within each age group were assessed using annual percent change (APC) estimates with 95% confidence intervals (CI). APCs were considered significant if the CI did not include zero. Analyses were further stratified by tumor behavior (malignant versus non-malignant) to identify contributors to observed trends. Results: Females aged 60 years and older disproportionately contributed to the increase in oral cavity cancer incidence from 2000 to 2022. A statistically significant rise was observed in this age group from 2010 to 2022 (APC 0.4; CI 0.1-0.7; p < 0.05) compared with 2000–2010 (APC 0.2; CI -0.4-0.7). In contrast, women younger than 60 years did not demonstrate a statistically significant change in incidence over the same period (APC 0.4; CI: −0.2–0.5). When stratified by tumor behavior, the increase in incidence among women aged 60 years and older was driven primarily by invasive oral cavity cancers (APC 0.4; CI: 0.1–0.8; p < 0.05). In contrast, benign lesions did not demonstrate statistically significant contribution to this trend (APC 0.7; CI -0.7 - 2.1). Detailed age-stratified APC estimates are shown in Table 1. Conclusions: This analysis demonstrates a growing burden of invasive oral cavity cancer among women aged 60 years and older. While prior SEER analyses have suggested this trend exists for women aged 50–64 years, our findings refine this observation to females older than 60 and invasive cancers as primary drivers. This suggests potential gaps in early detection or evolving risk factors in older women and underscores the need for age-targeted screening and prevention strategies. APC of oral cavity cancer among women by age group. Age 2000-2010 APC 95% CI 2011-2022 APC 95% CI <40 0.7 -0.7-2.1 -0.5 -1.6-0.6 40-49 -0.6 -1.5-0.3 -1.4** -2.0- -0.8 50-59 0.7** 0.4-1.0 -0.6** -1.2- -0.1 60-69 0.5 -0.1-1.1 0.8** 0.2-1.4 70+ 0.2 -0.4-0.8 1.1** 0.5-1.7 <60 0.4 -0.1-0.9 0.1 -0.2-0.5 >60 0.2 -0.4-0.7 0.4** 0.1-0.7 **Indicates statistically significant p-value < 0.05.