Characterizing the Burden of Tobacco-Associated Cancers in Oklahoma: A Demographic and Geographic Perspective,...

Despite declining national smoking rates, Oklahoma continues to experience high tobacco use, particularly among groups such as American Indian/Alaska Native (AI/AN) and rural populations. Cigarette smoking is a leading cause of cancer, and tobacco-related cancer incidence remains a significant public health concern in Oklahoma.

Articles were selected through a structured literature search and narratively summarized by key study characteristics and results. We then analyzed tobacco-related cancer incidence data from the Oklahoma Central Cancer Registry (1999-2022), focusing on cancers identified by the CDC as tobacco-related. Rates were age-adjusted to the 2000 US standard population. We assessed trends using Joinpoint regression and stratified findings by age, sex, race/ethnicity, rurality, and insurance status.

Between 2018 and 2022, 48,552 tobacco-related cancer cases were reported in Oklahoma, comprising 42% of all cancers. The age-adjusted incidence rate (AAIR) was 278.0 per 100,000. Males (253.5) had higher rates than females (161.3). The highest AAIR was among NH AI/AN individuals (257.5), with 52% of their cancers tobacco-related. Lung, colorectal, and kidney cancers were the most common tobacco-related cancers. Rural areas had higher incidence rates than their urban counterparts. Tobacco-related cancer rates declined over time (APC -0.55%, p < 0.0001), while non-tobacco-related cancer rates slightly increased. A weak positive correlation (r² = 0.29) was found between county-level smoking prevalence in 2010 and cancer incidence a decade later.

Tobacco-related cancers remain prevalent in Oklahoma, especially among males, rural, and AI/AN populations. Although incidence is declining, disparities persist. These findings underscore the ongoing need for targeted tobacco control efforts to address inequities and reduce cancer burden.