Mortality trends for oral and oropharyngeal cancer in Latin American and Caribbean countries, 1997 to 2020

Background: Oral and oropharyngeal cancer represents a significant public health challenge in Latin America and the Caribbean (LAC). Risk factors such as tobacco and alcohol consumption, human papillomavirus (HPV) infection, and disparities in healthcare access influence mortality trends. Understanding these trends is crucial for developing targeted prevention and control strategies in the region. This study assesses oral and oropharyngeal cancer mortality trends in LAC from 1997 to 2020. Methods: We conducted an ecological and observational time-series study that included analysis of data from the World Health Organization mortality database, covering the period from 1997 to 2020. Age-standardized mortality rates per 100,000 person-years were calculated using the SEGI world standard population. Joinpoint regression analysis was employed to assess age-specific mortality trends, identifying significant annual percentage changes (APC) along with 95% confidence intervals (95%CI). APCs were considered significant based on p-values < 0.05. For countries with multiple joinpoints, we calculated the average APC (AAPC). Trends were compared by gender to identify significant differences in mortality patterns. Results: In 1997, the highest oropharyngeal cancer mortality rates among men were observed in Cuba, Uruguay, and Argentina, while among women, the highest rates were in Cuba, Venezuela, and Paraguay. In 2020, Cuba remained the country with the highest rates for both sexes. For oral cancer, Uruguay, Cuba, and Brazil had the highest male mortality rates in 1997, while Colombia, Cuba, and the Dominican Republic had the highest rates among women. In 2020, Brazil, Paraguay, and Cuba led in male mortality, whereas Colombia, Cuba, and Peru showed the highest rates among women. Significant decreases in mortality by oropharyngeal cancer were observed among men in Argentina, Chile, and Mexico, while among women, significant increases were reported in Brazil and Ecuador. In oral cancer, male mortality decreased in Puerto Rico, Argentina, and Colombia, with increases noted in Paraguay, Peru, Venezuela, and Cuba. Among women, mortality decreased in Cuba and the Dominican Republic but increased in Nicaragua, El Salvador, and Peru. Analysis by age group revealed mixed patterns, with significant decreases in younger males in countries such as Argentina and Brazil but concerning increases among younger females in Colombia and Peru. The parallelism analysis indicated significant differences in mortality trends between men and women across several countries. Conclusion: Mortality trends for oral and oropharyngeal cancer in LAC present geographical and gender-based disparities, underscoring the need for tailored public health strategies. Expanding HPV vaccination programs, strengthening tobacco and alcohol control policies, and improving access to early diagnosis and treatment are essential measures to reduce the burden of these diseases in the region.