Ⅰ. INTRODUCTION

Modern society has become an era of longevity to the point of being called an aging era. However, cancer has become a task to be solved in modern society because it has a fatal effect on not only healthy life but also human life. Oral cancer is the sixth most common cancer in humans (1). In the oral and maxillofacial region, various malignancies such as epithelial cancer, non-epithelial sarcoma, and dental tumors may occur. The most common oral cancer is squamous cell carcinoma. Although the oral cavity is an organ that can be easily inspected, it has been reported that it is often not found until malignant tumors progress (2). This can be a factor that makes early diagnosis and early treatment difficult, and can also affect survival rates.

Analysis of the survival rate of lip-oral-pharyngeal cancer can be seen as representing the survival rate of oral cancer. The survival rate of oral squamous cell carcinoma can be seen as a representative example of the survival rate of oral cancer. Sarode et al. (3) reviewed overall oral cancer in young and old people and reported better survival on average when oral cancer occurred in younger people. Another study on the 5-year survival rate of patients with oral cancer from 1998 to 2008 reported a 75.7% survival rate for all oral cancers analyzed (4). Early diagnosis and early treatment of cancer are important for a good prognosis of cancer patients.

In the meantime, prevention, diagnosis, and treatment of cancer have been continuously developed. However, research on the survival rate through long-term big data for oral cancer in Koreans is insufficient. The survival rate analysis of lip-oral-pharyngeal cancer can provide an opportunity to think about what more is needed for the reduction of oral cancer patients and good prognosis.

The purpose of this study is to identify the current status of lip-oral-pharyngeal cancer by analyzing the 5-year relative survival rate at 5-year intervals using long-term big data of lip-oral-pharyngeal cancer in Koreans.

Ⅱ. SUBJECTS AND METHODS

Big data for this study was used for academic purposes in 2023 KOSIS (Cancer Registration Statistics, Ministry of Health and Welfare]). The statistics table ID is DT_117N_A00021. From 1996 to 2020, the 5-year relative survival rates of all carcers in the human body and cancers in the lip-oral-pharynx were compared and analyzed at 5-year intervals. Lip-oral-pharyngeal cancer survival rates by 5-year period from 1996 to 2000, 2001 to 2005, 2006 to 2010, 2011 to 2015, and 2015 to 2020 were analyzed. After analyzing the cancer survival rates for both men and women, they were analyzed in detail by dividing them into men and women. Table 1 shows the big data of long-term cancer survival rates for 25 years.

Ⅲ. RESULTS

The 5-year relative survival rate for lip-oral-pharyngeal cancer in both men and women in a 5-year cycle from 1996 to 2020 is as follows. 47.4% from 1996 to 2000, 54.5% from 2001 to 2005, 61.1% from 2006 to 2010, 65.5% from 2011 to 2015, and 69.7% from 2016 to 2020 (Figure 1).

The 5-year relative survival rate for lip-oral-pharyngeal cancer by 5-year cycle in men from 1996 to 2020 is as follows. 41% from 1996 to 2000, 49.7% from 2001 to 2005, 56.9% from 2006 to 2010, 61.8% from 2011 to 2015, and 66.7% from 2016 to 2020 (Figure 2). Cancer survival rates in men have consistently shown an increasing trend of survival rates until recently. However, when compared with the overall survival rate of males and females, males tended to be somewhat lower.

The 5-year relative survival rates for lip-oral-pharyngeal cancer by 5-year cycle in women from 1996 to 2020 are as follows. It was 64.5% from 1996 to 2000, 68.1% from 2001 to 2005, 72.1% from 2006 to 2010, 74.5% from 2011 to 2015, and 75.8% from 2016 to 2020 (Figure 3). Cancer survival rates for women tended to be higher when compared to overall cancer survival rates for both men and women. Overall, women had better survival rates than men (Figure 4).

Figure 5 shows the 5-year relative survival rates for all cancers and lip-oral-pharyngeal cancer in a 5-year cycle from 1996 to 2020. Lip-oral-pharyngeal cancer had a higher survival rate. However, in the last 15 years from 2006 to 2020, the 5-year relative survival rate for lip-oral-pharyngeal cancer was lower than for all cancers.

Ⅳ. DISCUSSION

Oral cancer is the most common malignant disease of the head and neck (5). Among them, squamous cell carcinoma (SCC) is the most common. Despite advances in treatment, oral cavity SCC is frequently lethal with a modest 5 year survival (6). There may be cases where patients inevitably refuse treatment. The survival rate of patients who refused treatment for oral cancer was very low, and the 5-year survival rate was 31.1% for patients with early stage cancer and 12.6% for patients with stage 4 cancer (5). It has been reported that the reasons why oral cancer patients refuse treatment are old age, insurance coverage, and cases accompanied by other diseases (5). Analyzing the survival rate of oral cancer and examining factors affecting the survival rate will be of great help in seeking ways to increase the survival rate of oral cancer patients.

Ali et al. (7) reported that smoking, diagnosis period, and age were significantly correlated in a study on the incidence and survival rates of oral cancer from 1994 to 2009. Geum et al. (2) reported that the three most important factors affecting the survival rate of oral cancer are pathological TNM stage, postoperative recurrence, and postoperative cervical lymph node metastasis, among which postoperative cervical lymph node metastasis is the largest factor. Du et al. (8) reported the long-term survival rate of head and neck cancer, and reported that human papillomavirus 16 (HPV16), smoking, site, and stage had significant effects. Mitchell et al. (9) reported that there was an important correlation between the clear margin in terms of oral cancer survival rates and surgically removed lesions.

It was reported that the 5-year survival rate for oral squamous cell carcinoma from 1985 to 2005 was 64.4% (10). In our study, the 5-year relative survival rate for lip-oral- pharyngeal cancer in both men and women in a 5-year cycle from 1996 to 2020 is as follows. 47.4% from 1996 to 2000, 54.5% from 2001 to 2005, 61.1% from 2006 to 2010, 65.5% from 2011 to 2015, and 69.7% from 2016 to 2020. Overall, women had better survival rates than men in our study.

Zanoni et al. (11) reported that the presence or absence of lymph node lesions acted as a very strong factor in the survival rate after surgical and additional treatment of patients with oral squamous cell carcinoma from 1985 to 2015. Tasche et al. (10) reported that invasive lesions within 1 mm of the margin of a specimen removed after oral cancer surgery had a higher recurrence rate. When the survival rate and quality of life were evaluated after primary surgical treatment of patients with oral squamous cell carcinoma, it was reported that the patients presented with long-term dysphagia and difficulty chewing after surgical treatment (12).

Oral cancer survival rates have been reported to be higher in younger age, early diagnosis, and in married people (7). Bschorer et al. (12) reported that the 1-year survival rate was 88%, but the 5-year survival rate was 70% in patients with common-stage oral squamous cell carcinoma in a long-term retrospective study. In our study, through long-term big data research of 25 years, it was found that the 5-year relative survival rate of lip-oral-pharyngeal cancer in Koreans has increased in modern times. And the highest survival rate for recent lip-oral-pharyngeal cancer was 69.7%. And for the last 15 years, the relative survival rate of lip-oral-pharyngeal cancer has been shown to be lower than that of all cancers.

In conclusion, through this study, the recent survival rate of lip-oral-pharyngeal cancer in Koreans was found to be about 70%. The current status of survival rate through such long-term big data suggests that continuous efforts are needed to increase the survival rate of lip-oral-pharyngeal cancer in Koreans.