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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
UNITED STATES: Oral Cancer Deaths Declining Among Well- Educated
Genevra Pittman
December 13, 2011
Reuters Health (11.23.11) - Tuesday, December 13, 2011

A new study finds that mortality rates for mouth and throat cancer have been dropping since the early 1990s, but only among people with at least a high school education.

Researchers examined mouth and throat cancer data from 1993 to 2007 in 26 states. The registries documented 19,300 deaths among adults ages 25-64. Deaths declined an average 2 percent to 5 percent every year. However, when the team broke down the results by educational level, they found the downward trend held up only among black people with at least a high school education, and only among whites who had completed some college. At the end of the period studied, the cancers killed three per 100,000 white men, six per 100,000 black men, and one each of every 100,000 white and black women annually.

Among the 4,000 cases of cancer in sites known to be associated with human papillomavirus (HPV) - such as the throat, tonsils, and tongue - death rates only dropped significantly among more-educated black men, the study found. The rates increased among white men and some white women, especially the less-educated, reported Dr. Amy Chen, of Emory University School of Medicine in Atlanta, and colleagues.

The association of education with mortality may be due to higher rates of smoking, other oral cancer risks, and lack of timely health care access, the researchers suggested. This is the latest type of cancer to show a socioeconomic pattern, Chen noted.

"Investment in education is very important not only for the health status of the population, but also for the economic status of the population," Chen said.

Chen emphasized the importance of using protection during sexual contact, including oral sex. Vaccinating boys and girls against HPV may bring down the rate in years to come, she said.

Vaccination has not been definitively proven to prevent these cancers yet, cautioned Dr. Joseph Califano, a John Hopkins expert in the cancers who was not involved in the study. Many questions also remain about how oral sex and cancer are linked, he added.

The full study, "US Mortality Rates for Oral Cavity and Pharyngeal Cancer by Educational Attainment," was published in Archives of Otolaryngology--Head & Neck Surgery (2011;137(11):1094-1099).