Trends and Spatial Patterns of Oral Cancer Mortality in Ecuador, 2001-2016.

The aims of this study were to describe the temporal trend of OC from 2001 to 2016 and to analyze the space and space-time clusters of high mortality due to OC in Ecuador from 2011 to 2016. Methods . The present study is a mixed ecological study; the time trends were obtained using a Joinpoint regression model, space-time scan statistics was used to identify high-risk clusters, and Global Moran I index was calculated. Results . In Ecuador, between 2001 and 2016, OC caused a total of 1,025 deaths. Crude mortality rates significantly increased, with an APC (annual percentage change) of 2.7% ( p =0.009). The age-standardized mortality rate did not significantly increase (APC: 1.73%; p =0.08). The most likely cluster was detected in 2015, included 20 cantons. The second cluster included 38 cantons, in the years 2014 to 2016. The Global Moran I index for the study period showed a negative spatial autocorrelation (-0.067; p =0.37). Conclusion . Mortality due to OC in Ecuador significantly increased over the 16-year study period, the young groups being the most affected. Ecuadorian provinces present high variability in types of OC and cancer rates.