Global burden of lip and oral cavity cancer across adults aged ≥45 years from 1990 to 2021 and projections to 2050.

INTRODUCTION: As global population aging intensifies, the burden of lip and oral cavity cancer (LOCC) among middle-aged and older adults continues to worsen. This research systematically analyzed global LOCC burden trends among adults aged ≥45 years, aiming to inform evidence-based policy and public health strategies. METHODS: Key metrics were obtained from the GBD 2021 database including age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR). Their correlations with the sociodemographic index (SDI) were explored. Joinpoint models assessed trends via annual percent change (APC) and average annual percent change (AAPC). Bayesian Age-Period-Cohort (BAPC) models projected future trends. RESULTS: From 1990 to 2021, globally, the ASPR (EAPC=0.77; 95% CI: 0.72-0.82) and ASIR (EAPC=0.35; 95% CI: 0.29-0.41) of LOCC among adults aged ≥45 rose significantly, while ASMR (EAPC= -0.15; 95% CI: -0.20 - -0.09) and ASDR (EAPC= -0.25; 95% CI: -0.31 - -0.20) rates declined. Regionally, all SDI quintiles experienced rising ASPR and ASIR, with middle SDI regions showing the fastest growth. Low-middle and low SDI areas saw increases in ASMR and ASDR. A notable correlation was identified between ASPR, ASIR and SDI. East Asia and Oceania had the most severe increases in ASPR/ASIR and ASMR/ASDR, respectively. Males bore a greater burden than females. Population growth and epidemiological shifts drove the rise in ASIR and ASPR, with alcohol and tobacco use as key mortality contributors. Projections estimate ASPR will reach 61.81 (95% UI: 37.31-86.30) and ASIR 17.09 (95% UI: 11.95-22.23) by 2050, with ASMR and ASDR expected to initially decline before rising again. CONCLUSIONS: The study highlights the need for early prevention, especially in high-risk regions and among male adults aged ≥45 years, and emphasizes the importance of considering multiple factors in public health interventions for effective disease management.