Introduction: Oral cancer is the commonest cancer among Sri Lankan males for decades.Objectives: To describe the sex difference in site specific cancers in oral cavity and to analyse the incidence trends according to sex, sites and age category of oral cancer in Sri Lanka between 2005 and 2019 Methods: Data on oral cancers were obtained from National Cancer Registry, Sri Lanka (NCR-SL) from 2005 to 2019. Sex difference for lip, tongue and mouth cancers were analysed. Analysis was performed with Joinpoint Trend Analysis Software on age standardized incidence rate (ASR) to examine the trends in sites, sex and age group categories over a 15-year period.Results: Data ofa total of31 919 oral cancer patients (males: 24 982; 78.3%; females: 6937; 21.7%) were analysed.All three site specific sub types showed a higher incidence in males than females. ASR has increased over the 15-year period in both sexes. The proportional increase in incidence was higher for males (1.9-fold increase with ASR; 9.8 to 18.9, average annual percentage change (AAPC) of5.4; 95% CI: 4.1, 6.7) than females (1.55-fold increase with ASR; 2.9 to 4.5,AAPC of3.l; 95% CI: 1.8, 4.5; p<0.001 fortrend). A statistically significant increasing trend was detected in all three types according to anatomical sites and in both sexes with a higher proportional increase in lip cancers (AAPC ofl0.5; 95%CI: 5.9, 15.3 in males;AAPC of6.9; 95%CI: 1.5, 12.6 in females;p<0.05 fortrend).An increasing trend in ASR was detected for all age categories. The rate was higher in less than 40 years age groups in both sexes (AAPC of 6.5; 95%CI: 3.3, 9.8 in males;AAPC of7.8; 95%CI: 3.4, 12.4 infemales;p<0.05 for trend). Conclusions & Recommendations:The incidence of oral cancer in Sri Lanka has shown an increasing trend with a greater propor t ional rise in males. It showed a higher incidence in males than females in all three subtypes. Structured prevention, screening and early detection programmes have to be planned to reduce the burden of oral cancer in Sri Lanka.
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