Shelton J, Zotow E, Smith L et al. 25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis. BMJ 2024; DOI: 10.1136/bmj-2023-076962.

The effect of COVID-19 on the incidence of oral cancer is unknown.

Although the numbers of reported cancer cases rose by around 50% over the past 25 years, cancer mortality has reduced by about one-third in both sexes, reflecting the success of prevention programmes (eg smoking cessation), early detection (eg breast screening), improved diagnostic tests and more effective treatment.

The decrease in mortality was reported across most cancer types (n = 23), apart from liver, uterine and oral cancers which all showed increases. Of the four cancers which showed substantial increase in incidence (oral, liver, skin and kidney), all have strong associations with established risk factors. In the case of oral cancer, these include alcohol consumption, smoking and human papillomavirus (HPV), of which smoking accounts for 13% of cases and alcohol consumption 33%. The rise in incidence of oral cancer may have been greater if the reduction in smoking prevalence had not occurred.

This analysis provides a benchmark for the next decade, which will include the impact of COVID-19 on cancer incidence and outcomes.