Objective  To investigate the inequalities of oral cancer burden caused by socioeconomic development differences in worldwide from 1990 to 2019, to provide scientific evidence for the development of effective prevention and control policies.

Methods  The burden of disease data for this study was derived from the 2019 Global Burden of Disease Study, and the human development index (HDI) were from the Human Development Report 2020. Linear regression analysis was used to assess the correlation between age-standardized disability-adjusted life year (DALY) rates and HDI. The slope index of inequality (SII) and concentration index (CI) were used to evaluate the inequalities and their trends of oral cancer burden from 1990 to 2019.

Results  A total of 189 countries and territories were included in this study. The DALY rate for oral cancer in 2019 was 46.61[IQR(30.70, 64.97)]. The linear regression results showed a significant negative correlation between DALY rate and HDI level (ρ=-0.06, P<0.001). The burden of oral cancer exhibited significant inequalities among the 189 countries and territories, with an SII value of -107.16[95%CI(-127.60, -90.69)] in 2019. From 1990 to 2019, the SII value was below 0 and showed an increasing trend. The CI of oral cancer in 2019 was -1.35[95%CI(-2.88, -1.01)], and from 1990 to 2015, the CI was above 0 and showed a decreasing trend, while from 2016 to 2019, the CI was below 0 and showed an increasing trend.

Conclusion  From 1990 to 2019, there is a strong socioeconomic inequality in the oral cancer burden globally, which is more concentrated in countries with low levels of socioeconomic development, and shows a trend of exacerbation over time. In the future, it is necessary to focus on the allocation of medical resources in developing countries and implement more targeted measures to effectively address the inequality of oral cancer burden.

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