Background: Oral cavity and pharyngeal (OCOP) cancer is strongly associated with tobacco use and alcohol consumption. Kentucky consistently has one of the highest rates of tobacco use in the United States. The purpose of this study was to examine the differences in incidence rates in Kentucky as compared to nationwide data as well as regional differences within the state.
Method: Oral and pharyngeal cancer incidence data for the years 1995-2004 in Kentucky were obtained from Kentucky Cancer Registry (KCR). Data for the same time period for the United States were approximated using SEER*Stat 6.3.5 provided by the Surveillance, Epidemiology, and End Results (SEER) Program. Age-adjusted incidence rates and smoothed incidence rates by county were examined.
Results: The overall incidence of oral cavity and pharyngeal cancer in Kentucky was 12.1/100,000. This was significantly higher than the rate seen in the SEER data of 11.3/100,000 population (p < 0.05). This difference was more pronounced for males in Kentucky, where a 20% higher rate (19.2 vs 16.3/100,000 SEER) was observed. The vast majority of cases (62.1%) had a documented smoking history, and this number was higher in advanced stage disease (73%). Rates were lower in Appalachian regions (11.4/100,000) compared to non-Appalachian regions (12.4/10/ 100,000), p < 0.01, with additional geographic variations observed.
Conclusion: Kentucky has a higher incidence rate for oral cavity and pharyngeal cancer than the national average. The high prevalence of tobacco use in the state is likely a strong contributing factor. The etiology of regional patterns of incidence rates statewide requires further study.