Alcohol as a Risk Factor in Hnc, an Enormous Toll on the Lives and Communities

Abstract

INTRODUCTION Head and neck cancer (HNC) is the seventh most common cancer in the world. After smoking, alcohol consumption is a strong associated risk factor for HNC. Alcohol consumption has negative impact on health and social consequences. The existing literature shows that alcohol consumption along with smoking is an important risk factor for HNC. MATERIAL AND METHODS In this retrospective analysis of 12-years from 2001 to 2012, total 9,950 patients of histopathologically proven head and neck cancers, were included in the study. The patients were analyzed for their association with alcohol as an associated risk factor along with smoking in different HNC subtypes. RESULTS Male to female ratio was 7:1 and median age of presentation was 54-years. 59% patients were alcoholics (alcoholics only+ smokers as well as alcoholics), out of which 6% were alcoholics only and the strength of association differed between different HNC subtypes; maximum for oropharyngeal group (35%), and 7.6%, 5% and 10% for oral cavity, hypopharynx and larynx respectively. Further evaluation has shown that total smokers (smokers only+ smokers as well as alcoholics) were 89%, out of which 36% were smokers only. At last follow-up, no evidence of disease (NED) was seen in 15% patients among total alcoholics and in 20% patients among non-alcoholics. CONCLUSION The present retrospective study of HNC patients at a tertiary care centre over a period of twelve years concluded the strong association of alcohol consumption with HNC and its different subtypes. Alcohol problems have an enormous toll on lives and communities of the developing nations particularly in the populous regions of the world (e.g. in China and India). There is a need to raise awareness among the population about the negative implications of alcohol consumption and to minimize them.

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“…Hence, to decrease the patient load in tertiary care institutes, it is recommended to use fractionation schedule with two radiotherapy fractions per week. 11,12…”

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“…The incidence of Head & Neck Cancer (HNC) in our institute in past 20-years constitutes 30-40% of all the malignancies. 5 The mainstay of treatment in LAHNC is concomitant chemoradiation. The most common complication in radical chemoradiation is mucositis which usually leads to interruption of treatment.…”

“…The global burden of HNC accounts for 6,50,000 new cases and 3,50,000 deaths worldwide every year and a major proportion of regional malignancies in India. The incidence of Head & Neck Cancer (HNC) in our institute in past 20-years constitutes ⅓ rd of all the malignancies, 5 hence remains the main focus of preventing radiation induced side-effects. From the present study, we conclude that Benzydamine gargling is better than Povidone iodine gargling in decreasing the severity of chemoradiation induced oral mucositis in head and neck cancers.…”

A comparative evaluation of neoadjuvant chemotherapy followed by concomitant chemoradiation versus accelerated radiation therapy versus conventional radiation therapy in a locally advanced head and neck carcinoma

“…[11] People who use tobacco (including cigarettes, cigars, pipes, etc.,) or drink alcohol excessively are at much greater risk for developing HNCs. [3,4] Approximately, 70-80% of these patients are diagnosed with locally advanced disease and 30-50% with lymph node involvement. [12] Stage at diagnosis is the single most important determinant of prognosis.…”