Custom interval analyses further demonstrated a declining trend before the pandemic (1999–2019; AAPC=-0.2709%, 95% CI:-0.4281 to -0.1087, P < .001) and an increasing trend during the pandemic period (2020–2024; AAPC=1.2879%, 95% CI: 0.9922 to 1.6558, P < .001).
In conclusion, the age-adjusted mortality rate of oral malignancies in the United States underwent a significant trend reversal in 2009, after which it entered a phase of sustained increase and accelerated further during the 2020–2024 pandemic period.
Sex-stratified analyses showed that mortality among males declined during the prepandemic period, although this decrease did not reach statistical significance, whereas a significant increase was observed after 2020.