The causal link between socioeconomic status and oral cancer risk: Evidence from Mendelian Randomization and global burden of disease analysis (1990–2021)

Abstract

Objective

Oral cancer shows significant disparities across economic levels and genders. We examine trends and determinants of oral cancer burden in regions with varying Social Development Index (SDI) levels using epidemiological data and Mendelian Randomization (MR).

Methods

Data from the 2021 Global Burden of Disease (GBD) dataset were analyzed across various SDI regions. Temporal trends were assessed using annual percentage change (EAPC), and risk factor attribution, decomposition analyses, and age-period-cohort models were conducted. MR were used to examine the causal relationship between economic factors and oral cancer incidence.

Results

Oral cancer burden is higher in males. High SDI regions have lower incidence, mortality, and DALYs compared to low SDI regions, with later onset and more pronounced gender differences. Tobacco and alcohol use are major risk factors in high SDI regions, while chewing tobacco predominates in low SDI areas. In low-SDI regions, population growth increases the risk; aging boosts incidence in high-SDI areas. MR analysis showed a negative causal relationship between educational attainment, household income, and oral cancer risk (P < 0.05).

Conclusion

Improving socioeconomic factors, particularly education and income, may help prevent oral cancer. The burden is higher in low-SDI regions, among males, and among older people, indicating a need for targeted prevention.