TRENDS AND DIFFERENTIALS IN MORTALITY FROM CANCERS OF THE ORAL CAVITY AND PHARYNX IN THE UNITED-STATES, 1973-1987

Background. This analysis consisted of an examination of trends and differentials in mortality from cancers of the oral cavity and pharynx in the United States for a recent 15-year period. Methods. The authors have used national cause-of-death data for the United States and intercensal population estimates to examine mortality from oral and pharyngeal cancers between 1973 and 1987 and to study differentials according to gender, race, and region of residence. Results. The overall mortality rate from these cancers decreased by 19% during the 15-year period, with most of the decline occurring after 1979. Mortality was much higher for men than for women and for blacks than for whites throughout the interval. Despite the overall decline, mortality rates increased among blacks, especially among black men. Mortality was highest in the South Atlantic, New England, and Mid-Atlantic states and lowest in the Mountain states. Conclusions. The disparity between male and female mortality from oral and pharyngeal cancer stems mainly from differences in the likelihood of developing these cancers, whereas the differences between blacks and whites appears to arise more from differences in survival than in incidence. Different age patterns of mortality for blacks and whites exist, in which mortality among whites, but not among blacks, rises continuously with age. An unexplained finding ws that mortality rates were reported to have fallen in recent years, whereas incidence and survival rates have reportedly remained almost unchanged. This apparent inconsistency may have resulted from declines in the incidence of oral and pharyngeal cancers that have been masked by improved detection.