Epidemiological trends and characteristics of oral tongue cancer in females: systematic review and meta-analysis

The rising incidence of oral tongue cancer (OTC) among younger populations and females represents an emerging epidemiological shift for which the aetiology remains unclear. This systematic review and meta-analysis examined the epidemiological trends of OTC in female patients and aimed to identify related risk factors and exposures. Forty-nine studies were identified following PRISMA guidelines, with pooled analyses including 35,733 females and 57,821 males from 21 studies. Overall, females showed lower odds of developing OTC compared to males (odds ratio 0.51, 95% confidence interval 0.41-0.62; P < 0.001). However, females exhibited a significantly higher annual percentage change (APC) in OTC incidence when compared to males (P = 0.010), despite significantly lower rates of smoking and alcohol consumption habits (P < 0.001). This trend was particularly pronounced in developed countries compared to developing countries (P < 0.001). The younger OTC cohort showed distinct clinical features, lower human papillomavirus infection rates, and unique mutational profiles, although current data remain insufficient to form definitive conclusions. This review highlights an epidemiological shift in OTC characterized by significantly higher APC among females, particularly in developed countries and in Western nations.