To evaluate the incidence and mortality rates of oral cancer (OC) in China and to project the disease burden for the next 15 years, utilizing data from the Chinese Cancer Registry Annual Report (2004–2018).

National data of OC [ICD 10 codes C01-C06] were obtained from aforementioned report from 2004 to 2018. Using Joinpoint Regression Software to calculate the Estimated Annual Percent Change (EAPCs) and their corresponding 95% confidence intervals (CI) to assess the trends in incidence and mortality rates. Decomposition analysis assessed the contributions of demographic and epidemiological factors to the evolving burden of OC. Age-standardized rates (ASR) for OC incidence (ASIR) and mortality (ASMR) were projected for the next 15 years using a Bayesian Age-Period-cohort model integrated nested Laplace approximation (INLA).

From 2004 to 2018, the number of OC cases, deaths, ASR of incidence, and mortality increased in China. During the study period, the ASIR of OC remained stable with EAPCs of 0.55% (95% CI: -0.28 to 1.38) and ASMR increased with EAPCs of 6.01% (95% CI: 3.56 to 8.52). The ASIR and ASMR for males exhibited an upward trend. Specifically, the age group with the fastest increasing incidence and mortality of OC in both sexes was 30–34 years and 35–39 years, respectively. Population aging accounted for 57.17% of the increase in OC cases and 55.66% of the increase in OC deaths. According to the forecast, by 2033, the ASIR and ASMR of OC in males aged 15 and older are expected to rise to 3.53 and 1.52 per 100,000, respectively, while the ASIR for females is expected to remain stable at 0.99 per 100,000, with the ASMR anticipated to increase slightly to 0.80 per 100,000.

From 2004 to 2018, the overall ASMR of OC in China was on the rise, and the overall ASIR showed a stable trend, while the ASIR of male displayed an increasing trend. The prevention and control of OC is a serious task, and the current prevention strategy should be reoriented to prevent the increase of OC cases.