A 25-year perspective on tongue cancer-related mortality: Nationwide trends and disparities in the United States.

Abstract

e22543 Background: Tongue cancer represents a significant proportion of oropharyngeal cancers. Despite advances in treatment, disparities in mortality persist across demographic and geographic regions. This study investigates 25-year nationwide trends in tongue cancer-related mortality, with a focus on disparities related to age, sex, ethnoracial groups, and urbanization. Methods: We analyzed mortality data from the Centers for Disease Control and Prevention's (CDC) WONDER (Wide-Ranging Online Data for Epidemiologic Research) database, focusing on tongue cancer-related deaths among U.S. adults (≥ 25 years) from 1999 to 2023. Cases were identified using ICD-10 codes C01 and C02 for tongue cancers listed as either “underlying” or “contributing” causes of death in the multiple cause of death database. Age-adjusted mortality rates (AAMRs) per million (1,000,000) individuals were calculated by sex, age groups, ethnoracial groups, and urbanization status (1999–2020 for urbanization). Trends in overall AAMRs were analyzed using the Joinpoint Regression Program to calculate the average annual percentage change (AAPC), with statistical significance set at ≤ 0.05. Results: Between 1999 and 2023, 70,044 tongue cancer-related deaths were reported among U.S. adults. Overall, AAMRs significantly decreased from 1999 to 2011 (APC: -0.80; 95% CI: -1.38, -0.32; p < 0.01), followed by a significant increase until 2023 (APC: 1.88; 95% CI: 1.53, 2.35; p < 0.01). Sex-based analysis revealed consistently higher AAMRs among men (18.3; 95% CI: 17.4, 19.2) compared to women (7.1; 95% CI: 6.6, 7.6). Among age groups, older adults had the highest AAMR (38.6; 95% CI: 36.5, 40.5) compared to middle-aged (12.0; 95% CI: 11.2, 12.8) and young adults (1.2; 95% CI: 1.0, 1.5). AAMRs also varied by ethnoracial groups, with the highest rates observed in non-Hispanic (NH) White individuals (13.3; 95% CI: 12.7, 13.8), followed by NH Black (10.8; 95% CI: 9.4, 12.2), NH Asian or Pacific Islander (7.5; 95% CI: 5.7, 9.6), and Hispanic populations (7.4; 95% CI: 6.1, 8.8). The NH American Indian or Alaska Native population reported negligible deaths. Urbanization analysis showed slightly higher AAMRs in metropolitan areas (12.1; 95% CI: 12.0, 12.2) compared to non-metropolitan areas (11.9; 95% CI: 11.6, 12.1). Conclusions: Tongue cancer-related mortality exhibited a declining trend from 1999 to 2011, followed by a concerning rise through 2023, with substantial disparities across sex, age, ethnoracial groups, and urbanization. Older adults, men, and NH White populations had the highest AAMRs, while metropolitan areas showed slightly elevated mortality rates compared to non-metropolitan areas. These findings underscore the importance of targeted preventive measures, early detection, and equitable healthcare access to mitigate rising mortality rates and address disparities.