Objective　To analyze the disease burden of lip and oral cavity cancer (LOC) in five Asia regions (Central Asia, South Asia, Southeast Asia, East Asia, and the high-income Asia-Pacific region) from 1990 to 2023, and predict the future trends.

Methods　Based on the Global Burden of Disease (GBD) 2023 database, data on mortality, incidence, prevalence, and disability-adjusted life years (DALYs) of LOC were extracted. Joinpoint regression was used to analyze trends changes, and the age-period-cohort (APC) model was employed to assess the age, period, and cohort effects. Using a Bayesian age-period-cohort (BAPC) model, with 2023 observed value as the baseline, the disease burden trends for 2024—2035 were predicted.

Results　In 2023, South Asia had the heaviest LOC disease burden, ranking first in terms of age-standardized mortality rate (ASMR) (6.9/100,000), age-standardized incidence rate (ASIR) (10.72/100,000), age-standardized prevalence rate (ASPR) (31.71/100,000), and age-standardized DALY rate (ASDR) (197.22/100,000 per-son-years). In 2023, the incidence and mortality rates of LOC were higher in men than in women across all five regions, particularly in the 35-79 years age group. From 1990 to 2023, Southeast Asia experienced the largest increase in the overall disease burden of LOC, the average annual percentage change (AAPC) for ASMR, ASPR, ASIR, and ASDR were 0.46%, 1.63%, 1.04%, and 0.63%, respectively, while Central Asia showed the largest decrease in overall LOC disease burden, the AAPC for ASMR, ASPR, ASIR, and ASDR were -0.72%, 0.01%, -0.40%, and -0.87%, respectively. The APC model results indicated that the prevalence of LOC increased with age, concentrating in the population aged 60-80 years; the period-cohort effect showed that individuals from the same birth cohort have higher prevalence rates in recent years compared to the earlier years; the age-cohort effect indicated that, within the same age group, individuals born more recently had higher prevalence rates than those born earlier. The BAPC projection model indicated that the disease burden in South Asia will rise significantly by 2035 (ASMR: 5.4/100,000; ASIR: 9.7/100,000), while the disease burden in Central Asia will decline significantly (ASMR: 0.8/100,000; ASIR: 1.5/100,000).

Conclusion　The disease burden of LOC continues to increase in most of Asia, with significant regional differences. South and Southeast Asia should prioritize screening high-risk populations and implementing appropriate inter-ventions against risk factors such as tobacco and alcohol use. Epidemiological improvements in Central and East Asia offer valuable reference for other regions. Future attention should be paid to rapidly increasing mortality and incidence rates in South Asia and Southeast Asia, and optimize resource allocation, and conduct in-depth investigations into epidemiological mechanisms involving lifestyle and environmental exposures to inform regional prevention and control strategies.

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