Global, regional, and national burden of oral cancer from 1990 to 2021

The Global Burden of Disease (GBD) project provides valuable insights into the global, regional, and national burdens of oral cancer (OC). This study aimed to assess the burden of OC from 1990 to 2021, analyze associated risk factors, and project future trends up to 2050. Data on OC were derived from the GBD 2021 report using the International Classification of Diseases, Tenth Revision codes C00–C08. Incidence, mortality, and disability-adjusted life years (DALYs) were estimated using DisMod-MR 2.1. Age-standardized rates were applied to assess temporal patterns. An autoregressive integrated moving average model was used to forecast future trends, with model selection and performance evaluated using standard diagnostic criteria. Potential risk factors, including smoking, alcohol consumption, and tobacco use, were further examined using Mendelian randomization analyses. From 1990 to 2021, global incidence, mortality, and DALYs attributable to OC increased, particularly in regions with lower Socio-demographic Index (SDI) levels, while high-SDI regions showed relatively stable or declining mortality. Smoking remained a major contributor to the OC burden, with alcohol use and other behavioral risks also playing important roles. Autoregressive integrated moving average projections suggested a continued increase in DALYs and deaths by 2050; however, these forecasts depend on current exposure and reporting assumptions. OC continues to impose a substantial global health burden, especially in low- and middle-income countries. Although projections indicate a likely increase in the future disease burden, these estimates should be interpreted with caution due to uncertainties in GBD data and long-term modeling. Strengthened prevention and tobacco control strategies remain essential to mitigating future risk.