Introduction

Cancer of the oral cavity and pharynx is the fourth most common cancer in males and the eighth most common in females on a worldwide basis. Their incidence varies significantly in different countries. As a group, those cancers are relatively rare in northern Europe, but are common in the Latin countries of Europe and in the Indian subcontinent. The nasopharynx (ICD-9 147) is considered in Chapter 24; the salivary glands (ICD-9 142) at the end of this chapter.

Histology, classification and diagnosis

These cancers are predominantly squamous carcinomas. They are frequently preceded by leukoplakia, notably in the mouth. Numerous histological types of salivary glands cancer are described. The most frequent is pleomorphic adenoma of which most occur in the parotid gland. While initially benign, it has a tendency to recur and a proportion eventually become malignant.

Descriptive epidemiology

Incidence and time trends

Lip

Fairly high rates are seen in some fair-skinned populations, notably in Canada, where rates are generally above 5. The highest are in Newfoundland (15.1) and Saskatchewan (12.3) (Fig. 23.1). Rates above 10 are seen in rural Rumania, southern Ireland, Queensland, Australia and Sicily. Most rates, however, are less than 5 and in Asia rates range from nil to 0.1. In Israel the incidence is close to that seen in Europe.