Global oral health inequalities in incidence and outcomes for oral cancer: causes and solutions.

N. W. Johnson, S. Warnakulasuriya, P. C. Gupta, E. Dimba, M. Chindia, E. C. Otoh, R. Sankaranarayanan, J. Califano, L. Kowalski

Research output: Contribution to journalArticlepeer-review

151 Scopus citations


The mouth and oropharynx are among the ten most common sites affected by cancer worldwide, but global incidence varies widely. Five-year survival rates exceed 50% in only the best treatment centers. Causes are predominantly lifestyle-related: Tobacco, areca nut, alcohol, poor diet, viral infections, and pollution are all important etiological factors. Oral cancer is a disease of the poor and dispossessed, and reducing social inequalities requires national policies co-ordinated with wider health and social initiatives - the common risk factor approach: control of the environment; safe water; adequate food; public and professional education about early signs and symptoms; early diagnosis and intervention; evidence-based treatments appropriate to available resources; and thoughtful rehabilitation and palliative care. Reductions in inequalities, both within and between countries, are more likely to accrue from the application of existing knowledge in a whole-of-society approach. Basic research aimed at determining individual predisposition and acquired genetic determinants of carcinogenesis and tumor progression, thus allowing for targeted therapies, should be pursued opportunistically.

Original languageEnglish (US)
Pages (from-to)237-246
Number of pages10
JournalAdvances in dental research
Issue number2
StatePublished - May 2011
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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