Burden, Trends and Projection of Lip and Oral Cavity Cancer in Central, Eastern and Western Europe: From the Global Burden of Disease 2023 Study

ABSTRACT: Background: Lip and oral cavity cancer (LOCC) remains a significant issue in Europe, with an uneven public health burden. While trends have shifted, regional and sex-specific disparities persist due to modifiable risk factors. Using Global Burden of Disease 1990 to 2023 estimates, this study evaluates long-term trends and projects Europe's future LOCC burden. Methods: The Global Burden of Disease (GBD) Study data of 2023 were examined to evaluate the trends of incidence, prevalence, and mortality of LOCC in Central, Eastern, and Western Europe. We conducted a retrospective analysis of age-standardized incidence (ASIR), prevalence (ASPR), and mortality rates (ASMR), alongside disability-adjusted life years (ASDR). Trends over time were examined using Joinpoint regression to estimate average Annual Percent Change (AAPC:). Furthermore, ARIMA time-series models were employed to generate future burden for the period 2024 to 2033. Results: From 1990 to 2023, Europe showed a clear East-West divide in LOCC. Western Europe successfully lowered its death rates (AAPC: −1.08%) and disability rates (AAPC: −1.41%). However, Central and Eastern Europe saw new cases rise (AAPC: 0.63% and 0.60%) along with more alcohol-related deaths. The highest burden was in Russia and Hungary, where male DALYs rate reached 207 per 100,000. ARIMA forecasting shows this gap will grow by 2033; while Central Europe’s ASIR is expected to fall to 4.65 per 100,000, Eastern Europe’s prevalence is projected to rise to 18.12 per 100,000 population. Conclusion: Europe highlights widening variations in LOCC burden, with Western Europe achieving substantial progress while Central and Eastern Europe face continuous worsening trends;