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| Age-period-cohort analysis of the disease burden of oral cancer among the elderly in China from 1992 to 2021 |
| DU Changhan1, GAO Linxi1, LU Xinyu1, ZHAO Weijuan2, LI Ling1
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1. School of International Nursing, Hainan Medical University, Haikou, Hainan 570100, China;
2. Hainan Hospital Affiliated to Hainan Medical University, Haikou, Hainan 570100, China |
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Abstract Objective To investigate the age, period, and birth cohort effect of the incidence, mortality, and disability-adjusted life years (DALY) of oral cancer among the Chinese elderly from 1992 to 2021. Methods Data on oral cancer incidence, mortality, and DALY rate in the Chinese population aged ≥60 years from 1992 to 2021 were collected from the Global Burden of Disease 2021 (GBD 2021) database. The trends in the incidence, mortality, and DALY rate of oral cancer were analyzed using the average annual percent change (AAPC) and the age-period-cohort (APC) model. Results The incidence, mortality, and DALY rates of oral cancer among the Chinese elderly showed increasing trends (AAPC=2.262%, 0.548% and 0.360%, all P<0.05) from 1992 to 2021. The APC model revealed that the incidence, mortality, and DALY rate of oral cancer increased with age, peaking in the 85-<90 age group at 22.31/105, 16.69/105, and 171.41/105, respectively. Using the period 2002-2006 as the reference group, the risks of incidence, mortality, and disability of oral cancer showed increasing trends over time. The highest risk of incidence was observed in 2017-2021 (RR=1.450, 95%CI: 1.398-1.504), while the peak risks of mortality (RR=1.131, 95%CI: 1.097-1.166) and disability (RR=1.146, 95%CI: 1.118-1.175) both occurred in 2012-2016. With the 1925-1929 birth cohort as the reference group, the risk of oral cancer incidence showed an increasing trend with later birth years. The highest risk of incidence was observed in the 1955-1959 birth cohort (RR=1.788, 95%CI: 1.699-1.881). In contrast, the risks of mortality and disability exhibited relatively stable trends overall. Conclusions The disease burden of oral cancer among the Chinese elderly generally exhibited an increasing trend from 1992 to 2021, with particularly high burden observed among the elderly aged 85-<90 years. The incidence risk increased with time and year of birth.
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Received: 07 April 2025
Revised: 24 August 2025
Published: 16 September 2025
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