A call for action: closing the gap on ethnic disparities in oral cavity cancer care

Sep 23, 2026

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Oral cavity cancer incidence in the UK is rising, with Asian/Asian British and socioeconomically deprived groups at highest risk and evidence of worse radiotherapy outcomes in South Asian patients. Rates increased markedly since 2000, while limited ethnicity coding and recording constrains precise estimates. Nearly half of cases present at stage IV, requiring complex multimodal care. Evidence also indicates poorer 2-year disease-free survival and higher locoregional recurrence in South Asian individuals, influenced by healthcare access, risk-factor patterns, migration-related inequities, and incomplete exploration of interacting socioeconomic, cultural and behavioural factors.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Epidemiology

Rising incidence and risk patterns

Stage at diagnosis and treatment complexity

Evidence on ethnic disparities in outcomes

Potential drivers and healthcare inequities

Public health and service access priorities

British Journal of Cancer [www.nature.com/bjc](www.nature.com/bjc) COMMENT Epidemiology OPEN A call for action: closing the gap on ethnic disparities in oral cavity cancer care Nikila Patil 1,2,3,4, Zainab Lal5,6, Thiagarajan Sridhar1,2, Manish Pareek4,5,6,7,8 and Harriet S. Walter 1,2,3,4 ✉ © The Author(s) 2025 | | | | | --- | --- | --- | | | The incidence of oral cavity cancers in the UK is rising. Asian/Asian British ethnic groups and socioeconomically deprived groups are at highest risk with some evidence of worse disease outcomes in South Asian individuals receiving radiotherapy. This variation in | | | | | | | | | | | incidence and outcomes underscores the urgent need for action. | | | | | British Journal of Cancer (2025) 133:917–918; [https://doi.org/10.1038/s41416-025-03186-z](https://doi.org/10.1038/s41416-025-03186-z) | | | | | | The incidence of oral cavity cancers (OCC) in the UK is rising. In England, oral cancer rates, including cancers of the oral cavity and oropharynx, have increased by more than 130% since 2000, with mortality also steadily rising [1] . Accumulating evidence suggests that Asian/Asian British ethnic groups and socioeconomically deprived groups are at highest risk. Among Asian/ Asian British individuals, the incidence of OCC is 6.27 per 100,000, compared to 5.96 per 100,000 in White individuals. However, data is limited due to a lack of robust ethnicity data coding and recording [1, 2] . The variation by socioeconomic status is stark with a standardised incidence of 11.13 per 100 000 in the most deprived quintile compared to 6.68 per 100 000 in the least deprived [2] . The drivers of this increased risk are likely to be multifactorial encompassing not only inequities in access to healthcare services but also differences in knowledge, health behaviours and lifestyle risk factors. Biological determinants of disease may also play a role. The majority of oral cavity cancers are squamous cell carcinomas and the aetiology is strongly linked to risk factors including alcohol consumption and use of tobacco [2]. Alarmingly, around half of oral cavity cancers are diagnosed as Stage IV necessitating more complex and multimodal treatment, with in some situations, palliative treatment being the only option [2] . We recently reported worse disease outcomes in South Asian individuals, deﬁned as self-reporting as Indian, Pakistani and Bangladeshi, receiving radiotherapy for oral cavity cancers in a single centre serving a super-diverse community [3] . We found poorer 2-year disease-free survival in South Asian individuals compared to non-South Asian individuals, 54.6% vs. 73% respectively, even when adjusted for deprivation. Additionally, locoregional recurrence was more frequent in South Asian individuals compared to non-South Asian individuals, 42.5% vs 22.1% respectively, despite similar disease characteristics [3] . A similar study in Canada, also highlighted poorer outcomes in East Indian patients with OCC [4] . It is unknown whether ethnicity, independently, determines patient outcomes or whether there exists an interplay of socioeconomic, cultural and behavioural factors. Variations in genetic, biological and environmental factors between individuals may inﬂuence disease trajectory and treatment adherence, tolerability and resultant disease outcome [5] . This has not been fully explored within different ethnic groups. In the United Kingdom, although smoking remains the most common form of tobacco use across all communities, smokeless tobacco products, whose composition varies signiﬁcantly, are most commonly used by South Asian individuals, particularly those of Bangladeshi origin [6] . Recreational use of smokeless tobacco and betel nut is strongly linked with variation in the incidence of, and mortality from, oral cavity cancers globally with the highest rates in South-East Asia as well as in South Asian populations in the UK, particularly Indo-Asian immigrants[7

FAQs

Which UK groups face the highest risk for oral cavity cancer?

Asian/Asian British ethnic groups and socioeconomically deprived groups show the highest risk in the UK. South Asian individuals receiving radiotherapy have evidence of worse disease outcomes.

Why are estimates of ethnic differences limited in the UK?

Data limitations stem from a lack of robust ethnicity data coding and recording, which restricts detailed measurement of incidence and outcomes across groups.

What factors are suggested to drive higher risk and poorer outcomes?

Contributing drivers are likely multifactorial, including inequities in access to healthcare, differences in knowledge and health behaviours, lifestyle risk factors, and potentially biological and genetic or environmental determinants, with limited exploration across ethnic groups.

Sep 23, 2026

Uploaded by Aldword