Oral cancer morbidity

The number of deaths from oral cancer has been rising over the last 30 years. The death to registration ratio is 0.4, which is higher than many other cancers and similar to cancer of the uterine cervix and breast. The site in the mouth is an important prognostic indicator, with the tongue having the poorest prognosis and highest mortality (Table 17.2).

Table 17.2 Registration and deaths by site in Scotland 1991-1996

Site

Registrations (%)

Deaths (%)

Tongue

25.0

29.9

Unspecified mouth

19.2

19.5

Floor of mouth

17.6

12.9

Lip

14.5

2.4

Oropharynx

12.5

14.5

Ill-defined sites

6.3

16,5

Gum

4.7

4,2

Cancer surveillance group 1998

Survival rates have not improved over the past 50 years, mainly due to late presentation of patients with the disease. It has been shown that the delay in presentation correlates well with social deprivation. Education programmes are required to target the at-risk groups, and only when lifestyle begins to change is there a likelihood of an improvement in survival.

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