Current topics in the epidemiology of oral cavity and oropharyngeal cancers

Abstract

Oral cancer incidence rates rose dramatically during the twentieth century in the United States and Europe, especially among individuals under the age of 60 years. Although influenced by age, sex, and country of origin, incidence trends were most strongly affected by elevated risk among individuals born after approximately 1915. This cohort effect was indicative of strong behavioral influences on oral cancer risk. In this article, associations between oral cancer risk and established behavioral risk factors including alcohol and tobacco use are reviewed. Additionally, possible associations between oral cancer risk and oral hygiene, diet, nutritional status, and sexual behavior as well as the influence of genetic factors on oral cancer risk are considered. Special emphasis is placed on evaluating possible risk differences in individuals above and below the age of 45 and in users and nonusers of alcohol and tobacco. Oral squamous cell carcinomas arise from several anatomic sites within the oral cavity and oropharynx, but most commonly from the oral, mobile tongue.1 In the 1980s, 2 cancer centers in the United States (U.S.) reported an increase in the proportion of incident oral tongue cancers diagnosed in men younger 40 years.2,3 Although absolute numbers had increased, these reports provided no real evidence of rising incidence. Shortly thereafter, however, a significant 2-fold increase in oral tongue cancer mortality rates between 1950 and 1982 was reported in the U.S. for men younger than 30 years. 4 This finding was corroborated by a study in Scotland. 5 Further analysis of the Scottish data revealed that the increase in incidence was not restricted to those younger than 40 but extended to all age groups less than 65 years of age born after 1920-a strong ''cohort effect.'' The cohort effect was indicated by a strong effect of year of birth on oral cancer incidence rates. A flurry of research on global changes in oral cancer incidence was stimulated by these reports.

Oral Cancer Knowledge, Attitudes, and Practices among Dentists in Khartoum State, Sudan

“…Infectious agents have been implicated in some cancers of the oral cavity and pharynx, particularly in younger populations (Gillison, 2007). Recent epidemiological and experimental data have implicated infection with human papilloma virus in the pathogenesis of oral cancer; and suggest that about 35 % of all oral cancers are positive for HPV DNA (Kreimer et al, 2005), with 90 to 95 % positive for HPV-16 et al, 2007).…”

Effectiveness of an Intervention Program on Knowledge of Oral Cancer among the Youth of Jazan, Saudi Arabia

“…Alcohol and smoking alone are responsible for 80% of the cases in males, 61% in females and 74% overall (Warnakulasuriya et al, 2005;Gillison, 2007;Petersen, 2009). Lack of awareness of the risk factors among the community (Pakfetrat et al, 2010;Peker and Alkurt, 2010), un-presented early lesions or delayed diagnosis of cancer makes the job even more challenging for the health care provider (Warnakalasuriya et al, 1999).…”

Current Views and Perspectives on Classification of Squamous Intraepithelial Lesions of the Head and Neck

“…In addition, the comparative epidemiology of HPV infection and associated cancers of the head and neck and cervix, revealed that the global incidence of head and neck SCC and cervical SCC is similar; however, a minority of HNSCC, in comparison to virtually all cervical SCC, are caused by HPV. HPV prevalence is considerably lower in the oral than anogenital region for reasons that are still unclear, in spite of the fact that HPV infection in both sites is strongly associated with sexual behavior [31]. Only a significant fraction of oropharyngeal HNSCC is strongly etiologically associated with HPV infection.…”