Profiling the oral cancer population in Hong Kong

Abstract

Objectives: Oral squamous cell carcinoma (SCC) is a lethal and deforming disease with rising incidence and global significance; 300,000 new cases are seen each year, including 40,000 in China alone. Despite advances in management, 50% of patients die within 5 years of diagnosis. Cancer is the leading cause of death in Hong Kong, with the Hong Kong Cancer Registry (HKCR) confirming a 2% increase in new cases each year, and oral SCC the tenth leading cause of cancer death in males. Strategies to improve clinical outcome require identification and early intervention in the ‘high-risk’ population. Unfortunately, demographic information is limited in HKCR making it difficult to undertake accurate population-based studies. This study aimed to profile the demographics of oral cancer within the Hong Kong population. Methods: Following local ethical approval, the Hong Kong Hospital Authority database was accessed to identify new cases of oral SCC diagnosed and treated during an 18-year period (January 2000 to December 2017). Results: 6,706 oral cavity SCC cases were identified: 4291 male (mean age 64yrs) and 2,415 female (mean age 65.7yrs). A trend for increasing number of cases per year was seen. The tongue was the most commonly affected site in 3168 patients, with tonsil (863), buccal mucosa (539) and floor of mouth (409) less common. Mean survival time was 1.9 years, greatest for vestibule, buccal and labial commissure SCCs (2.6 to 3.0yrs) and least for oropharynx and hard palate tumours (0.97 to 1.1yrs). Conclusions: Whilst useful HKCR data are available regarding age, sex, site and outcome, there is need for improved demographic profiling to better characterise the ‘high risk’ oral cancer population in Hong Kong.