1. Epidemiology of Oral Cancer Module 1:

2. Epidemiology of Cancer, U.S.

3. US Mortality, 2001 Source: US Mortality Public Use Data Tape 2001, National Center for Health Statistics, Centers for Disease Control and Prevention, 2003. 1.Heart Diseases700,142 29.0 2.Cancer553,768 22.9 3.Cerebrovascular diseases163,538 6.8 4.Chronic lower respiratory diseases123,013 5.1 5.Accidents (Unintentional injuries)101,537 4.2 6.Diabetes mellitus 71,372 3.0 7.Influenza and Pneumonia 62,034 2.6 8.Alzheimer’s disease 53,852 2.2 9. Nephritis 39,480 1.6 10.Septicemia 32,238 1.3 RankCause of Death No. of deaths % of all deaths

4. 2004 Estimated US Cancer Cases* *Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder. American Cancer Society, 2004. Men 699,560 Women 668,470 32%Breast 12%Lung & bronchus 11%Colon & rectum 6%Uterine corpus 4%Ovary 4%Non-Hodgkin lymphoma 4%Melanoma of skin 3%Thyroid 2%Pancreas 2%Urinary bladder 20%All Other Sites Prostate33% Lung & bronchus13% Colon & rectum11% Urinary bladder6% Melanoma of skin4% Non-Hodgkin lymphoma4% Kidney3% Oral Cavity3% Leukemia3% Pancreas2% All Other Sites18%

5. Lifetime Probability of Developing Cancer, by Site, Men, US, 1998-2000 Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 5.1 Statistical Research and Applications Branch, NCI, 2003. http://srab.cancer.gov/devcan SiteRisk All sites 1 in 2 Prostate 1 in 6 Lung & bronchus1 in 13 Colon & rectum1 in 17 Urinary bladder1 in 29 Non-Hodgkin lymphoma1 in 48 Melanoma1 in 55 Kidney1 in 69 Leukemia1 in 70 Oral cavity1 in 72

6. Lifetime Probability of Developing Cancer, by Site, Women, US, 1998-2000 Source:DevCan: Probability of Developing or Dying of Cancer Software, Version 5.1 Statistical Research and Applications Branch, NCI, 2003. http://srab.cancer.gov/devcan SiteRisk All sites 1 in 3 Breast 1 in 7 Lung & bronchus 1 in 17 Colon & rectum 1 in 18 Uterine corpus 1 in 38 Non-Hodgkin lymphoma 1 in 57 Ovary 1 in 59 Pancreas 1 in 83 Melanoma 1 in 82 Urinary bladder 1 in 91 Uterine cervix1 in 128

7. Estimated New Oral Cancer Cases & Deaths by Sex, US, 2004* Estimated New Cases Estimated Deaths Both Sexes Male Female Both Sexes Males Females All sites 1,368,030 699,560 668,470 563,700 290,890 272,810 Oral cavity/pharynx 28,260 18,550 9,710 7,230 4,830 2,400 Tongue 7,320 4,860 2,460 1,700 1,100 600 Mouth 10,080 5,410 4,670 1,890 1,070 820 Pharynx 8,250 6,330 1,920 2,070 1,460 610 Other oral cavity 2,610 1,950 660 1,570 1,200 370

8. What is oral cancer?  Cancer that starts in the mouth is oral cavity cancer –Includes lips –Inside lining of cheeks (buccal mucosa) –Gingiva (gums) –Floor of the mouth –Anterior 2/3rds of the tongue –Hard palate

9. Oropharyngeal cancer  Refers to cancers that start in the oropharynx (posterior to the oral cavity)  For convenience, these modules will refer to oral cavity and oropharyngeal cancers as “oral cancer”

10. Oropharyngeal Cancers: Statistics for the United States  The American Cancer Society estimates 29,370 new cases of oral cavity and oropharyngeal cancer in 2005  About 7,320 will die from the disease during 2005

11. Cancer Survival*(%) by Site and Race,1992-1999 *5-year relative survival rates based on cancer patients diagnosed from 1992 to 1999 and followed through 2000. Source: Surveillance, Epidemiology, and End Results Program, 1975-2000, Division of Cancer Control and Population Sciences, National Cancer Institute, 2003. All Sites64 53 11 Breast (female)88 74 14 Colon & rectum63 53 10 Leukemia48 39 9 Non-Hodgkin lymphoma57 47 10 Oral cavity60 36 24 Prostate99 93 6 Urinary bladder83 64 19 Uterine cervix73 61 12 Site White% Difference African American

12. 13.1.2 The totals in this figure include unstaged cancers. Data source: Surveillance, Epidemiology, and End Results (SEER) 11 Registries Public-Use, August 1999 Submission (1992-1997). The rates are per 100,000 and are age-adjusted to the 1970 U.S. standard population. Incidence rates for oral and pharyngeal cancers (1992-1997) by stage at diagnosis &race/ethnicity

13. 13.1.3 * The totals in this figure include the unstaged cancers. Data source: Surveillance, Epidemiology, and End Results (SEER) 9 Registries Public-Use, August 1999 Submission (1993-1997). The rates are per 100,000 and are age-adjusted to the 1970 U.S. standard population. Incidence rates for oral and pharyngeal cancers (1992-1997) by stage at diagnosis and gender

14. 13.2.1 Data source: 1998 National Health Interview Survey, National Center for Health Statistics, Centers for Disease Control and Prevention. Percentage of adults aged 40 and older who reported having had an oral cancer examination in the past year

15. 13.3.1 * Age adjusted to the year 2000 U.S. standard population. Data source: 1998 National Vital Statistics System, National Center for Health Statistics, Centers for Disease Control and Prevention. Oral and pharyngeal cancer deaths (per 100,000*) in 1998 by race/ethnicity, gender and education

16. State of Illinois Statistics

17. Average Annual Age-adjusted Rates and Distributions Oral Cavity and Oropharyngeal Cancer Incidence and Mortality by Subsite All Races, Both Sexes, Illinois vs. National, 2000 IncidenceMortality IllinoisSEER†IllinoisU.S.‡ SiteRateCount%RateCount%RateCount%RateCount% Lip0.6766.10.92208.10.041.20.0630.9 Tongue2.529423.42.666324.50.78024.40.61,68723.6 Salivary Gland1.113210.51.334412.70.2278.20.26368.9 Floor of Mouth1.01239.80.71856.80.1103.00.11432.0 Gum/Other Mouth 1.619215.31.844516.40.55717.40.41,15616.1 Nasopharynx0.6776.10.71696.20.2226.70.26288.8 Tonsil1.315412.31.333712.50.2257.60.24936.9 Oropharynx0.4524.10.3792.90.2257.60.25217.3 Hypopharynx0.91088.60.82047.50.1113.40.13484.9 Other Oral Cavity 0.4473.70.2602.20.66720.40.61,48820.8 Total10.51,255100.010.62,706100.02.7328100.02.77,163100.0

18. Stage at Diagnosis of Oral Cavity and Oropharyngeal Cancer Incidence Average Annual Percentages for 5-year Time Periods All Races, Both Sexes, Illinois, 1986-2000 Source: Illinois Department of Public Health, Illinois State Cancer Registry, January 2003

19. Incidence & Mortality, Buccal Cavity and Pharynx, Both Sexes, 1986-2000 All RacesWhitesBlacksAsian/Other IllinoisCountRateCountRateCountRateCountRate Incidence18,20110.914,69310.13,01414.93078.2 Mortality5,5043.34,2842.91,1535.8671.7 State of Illinois Illinois Department of Public Health, Illinois State Cancer Registry, January 2003

20. State of Illinois Statistics Incidence Rate for Oral Cancer, 1993-1997 Illinois US WomenMenWomenMen 5.314.45.915.3 American Cancer Society, 2004

21. Illinois Statistics Mortality Rate for Oral Cancer, 1993-1997 Illinois US WomenMenWomenMen 1.34.31.43.8 American Cancer Society, 2004

22. Stage at Diagnosis of Oral Cavity and Oropharyngeal Cancer Incidence § Average Annual Percentages for 5-year Time Periods All Races, Both Sexes, Illinois, 1986-2000 Figure 11 Oral Cavity and Oropharyngeal Cancer Incidences, 1986-2000 (Site-Race-Ethnicity)  Includes only invasive cancers. Hispanics/non-Hispanics are not mutually exclusive from whites, blacks and  Asian/other races.Source: Illinois Department of Public Health, Illinois State Cancer Registry, January 2003

23. Oral Cavity and Oropharynx Average Annual Age-adjusted Cancer Rates by Gender and Race/Ethnicity in Illinois, Incidence§ and Mortality, 1996-2000

24. Percentage Cases Diagnosed at Early Stage Oral Cavity and Oropharyngeal Cancer Incidence§ Illinois Counties, 1986-2000 Figure 14 Oral Cavity and Oropharyngeal Cancer Incidence in Illinois Counties (1986-2000)

25. Summary  Oropharyngeal cancers are prevalent throughout the U.S. and in the State of Illinois  Men face a greater risk than women, with African American men facing the greatest risk