Lip and Oral Cavity Cancer Worldwide in 2024: A Comprehensive Ecological Study of Burden, Socio-Demographic Disparities, and Population-Level Risk Factors

Background. Lip and oral cavity cancer (LOCC) remains a substantial global cancer burden with marked sex and geographical disparities. Updated global estimates integrating cancer burden, behavioral exposures, and socioeconomic context are needed to clarify current patterns and identify population-level priorities for prevention and control. Methods. We conducted an ecological analysis of GLOBOCAN 2024 LOCC estimates (ICD-10 C00-C06) across 186 countries. Age-standardized incidence (ASIR) and mortality rates (ASMR) were examined by sex, region, and income level. Associations with age-standardized smoking and alcohol Summary Exposure Values and Human Development Index (HDI) indicators were evaluated using multivariable linear regression, with historical analyses based on 1990 and 2010 data. Results. In 2024, an estimated 452,062 new LOCC cases (ASIR: 4.5 per 100,000) and 194,059 deaths (ASMR: 1.9) occurred globally, with higher ASIR and ASMR among males than females. In fully adjusted ecological models, smoking prevalence was positively associated with ASIR among females (β=0.349, p=0.012), while alcohol use was positively associated with both ASIR (β=0.275, p=0.006) and ASMR (β=0.206, p=0.046) among males. Historical analyses from 1990 and 2010 showed substantial directional concordance with contemporary associations, indicating persistent but sex-specific ecological patterns across the examined periods. Conclusion. LOCC continues to impose a substantial and uneven global burden, with distinct sex-specific associations involving tobacco and alcohol exposure. Socioeconomic development showed no independent fully adjusted association with LOCC outcomes. These findings support context-specific prevention, sustained exposure surveillance, and stronger early detection and treatment capacity.