Quantifying the Oral Cancer Public Awareness Deficit in Germany (2015-2023)

Objective: To quantify the gap between oral cancer disease burden and public awareness in Germany, and to characterize research dissemination patterns across social media platforms. Methods: We conducted a multi-dimensional analysis integrating: (1) Robert Koch Institut cancer registry data for oral and maxillofacial malignancies (ICD-10: C00-C06) from 2015 to 2023; (2) Google Trends search interest for cancer-related German terms; (3) Altmetric data for 2581 PubMed-indexed oral cancer publications; and (4) sentiment analysis of 10,308 social media posts. Age-standardized incidence rates were calculated using the European Standard Population. Results: Over the study period, 65,757 oral cavity cancer cases were registered. Google Trends analysis revealed a 64% attention deficit for "Mundkrebs" (oral cancer; mean: 17) compared to "Brustkrebs" (breast cancer; mean: 47). Case numbers declined from 7577 (2019) to 6870 (2023; -9.3%), while age-standardized rates decreased by 15.5% (11.6 to 9.8 per 100,000), with males disproportionately affected (-17.7%). Research dissemination was dominated by X/Twitter (86.2%), with minimal policy document (0.3%) or clinical guideline (0.3%) citations. Sentiment analysis revealed 77% positive public reception. Regional analysis identified an East-West divide, with Eastern German states showing 22% higher search interest. Conclusions: A substantial public awareness deficit exists for oral cancer in Germany, paradoxically widening during a period of declining diagnoses potentially associated with COVID-19-related diagnostic delays. The positive public sentiment toward oral cancer research suggests a favorable environment for targeted awareness campaigns, particularly in Western German states where search interest is lowest. These findings have practical implications for designing regionally tailored awareness campaigns prioritizing anatomically specific terminology. Future research should evaluate the effectiveness of such targeted interventions and assess whether post-pandemic diagnoses present at more advanced stages.