Global oral health inequalities in incidence and outcomes for oral cancer: causes and solutions

Adv Dent Res. 2011 May;23(2):237-46. doi: 10.1177/0022034511402082.

Abstract

The mouth and oropharynx are among the ten most common sites affected by cancer worldwide, but global incidence varies widely. Five-year survival rates exceed 50% in only the best treatment centers. Causes are predominantly lifestyle-related: Tobacco, areca nut, alcohol, poor diet, viral infections, and pollution are all important etiological factors. Oral cancer is a disease of the poor and dispossessed, and reducing social inequalities requires national policies co-ordinated with wider health and social initiatives - the common risk factor approach: control of the environment; safe water; adequate food; public and professional education about early signs and symptoms; early diagnosis and intervention; evidence-based treatments appropriate to available resources; and thoughtful rehabilitation and palliative care. Reductions in inequalities, both within and between countries, are more likely to accrue from the application of existing knowledge in a whole-of-society approach. Basic research aimed at determining individual predisposition and acquired genetic determinants of carcinogenesis and tumor progression, thus allowing for targeted therapies, should be pursued opportunistically.

MeSH terms

  • Alcohol Drinking / adverse effects
  • Areca / adverse effects
  • Dental Research*
  • Global Health*
  • Health Education
  • Health Policy
  • Health Priorities
  • Health Services Accessibility
  • Health Status Disparities*
  • Humans
  • Incidence
  • Mass Screening
  • Mouth Neoplasms / epidemiology*
  • Mouth Neoplasms / etiology
  • Mouth Neoplasms / therapy
  • Oral Health*
  • Precancerous Conditions
  • Risk Factors
  • Socioeconomic Factors
  • Tobacco / adverse effects
  • Treatment Outcome