June 2006

Objectives: To estimate the burden and risk of oral cancer in Saudi Arabia and highlight differences between regions. Methods: Using the National Cancer Registry Saudi Arabia, data was collated on numbers of cases of oral cancer (1996-1998) by site, age group, gender and region, plus relative frequencies of all cancer cases. Using Globocan, age-standardised rate (ASR) of oral cancer in Saudi Arabia was compared with five other neighbouring countries in the region. Results: A total of 208 lip, mouth and tongue cancers for men and 209 for women were reported to the registry during this period. ASR of oral cancer was 1.81/100,000 for males and 2.13/100,000 for females. It was ranked 15th most common cancer for males and 11th for females, with a ratio of 1:1 and median age at diagnosis of 62 years. Very wide regional disparities in the incidence of oral cancer were found, with an almost thirty-fold difference in ASR between the regions with the lowest and highest rates. Jizan Region had the highest ASR (6.2/100,000 for males and 9.82/100,000 for females). Here oral cancer was ranked 2nd for males and 1st for females, with a ratio of 0.73:1 and the median age at diagnosis for females was lower. The third highest ASR (4.48/100,000) was found in females in Najran. In these two high incidence regions oral cancer was commonly reported on the gingiva. Conclusions: Overall the burden and risk of oral cancer in Saudi Arabia are not large. However, cancer of the oral cavity is a significant public health problem for the residents of Jizan and the women of Najran. Saudi females in both these regions have a higher burden of oral cancer. Key words: Incidence, oral cancer,Saudi Arabia, shamma, tobacco