Head and Neck Squamous Cell Carcinoma in Iranian Patients and Risk Factors in Young Adults: a Fifteen-Year Study

Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is the 8th most common cancer worldwide. Although older age, male gender, smoking and alcohol consumption are known risk factors, an increasing number of HNSCC patients are without typical risk factors. Our aim was to define demographics of HNSCC in Iran and the potential risk factors related to Iranian ethnicity and lifestyle. Methods: We conducted a crosssectional analytical study on 262 patients with primary SCC of the larynx, hypopharynx or tongue referred to our pathology department during 1995-2010. Patients' demographics, tumor characteristics and risk factors such as smoking, alcohol consumption and anemia were analyzed and compared in two groups of patients: over 40 years (older group) and 40 years or less (young group); Chi-square and Mann-Whitney analytical tests were employed. Results: 5.7% of patients were young adults. The male to female ratio was 1.5 in the younger group and 5.6 in the older group. In young adults, 40% of tumors were located in larynx and 40% in the tongue. Age >40 was significantly associated with laryngeal location (P<0.001). History of smoking and drinking was significantly associated with age >40 and SCC of larynx in both age groups. Cervical lymph node involvement was significantly correlated with SCC of tongue (P<0.001), however, considering young adults only, SCC of hypopharynx was most frequently accompanied by lymph node involvement (60%). The most prevalent tumor among men was SCC of larynx whereas SCC of hypopharynx was the most prevalent tumor among women (61%), of whom 18.2% were ≤40. Conclusions: The incidence of HNSCC among young adults seems to be higher in Iran compared to other countries. Reduction in exposure to known risk factors, especially tobacco smoking in forms of cigarettes and bubble pipes, and search for other causative agents of HNSCC in young population is recommended.

Prevalence of Head and Neck Cancer in Gilan Province, Iran: A 10-Year Study

“…(15) Mirzaei et al and Mafi et al reported that the thyroid and larynx cancers were the most prevalent head and neck malignancies, which confirmed our results. (16,17) Additionally, our results showed that head and neck cancer patients were usually in the eighth (25%) and seventh (21%) decades of life. Shahsavari et al also studied head and neck cancer patients in Tehran, Iran, and arrived at the same conclusion that the eighth (27%) and seventh (22%) decades of life were the most common decades for the development of head and neck cancer.…”

Risk Stratification of Early Stage Oral Tongue Cancers Based on HPV Status and p16 Immunoexpression

“…(Elango et al, 2006) Earlier reports have shown that tongue cancer has increased among the non-tobacco users, suggesting a review of the clinico-epidemiological factors and molecular changes in OTSCCs. (Mafi et al, 2012;Arvind Krishnamurthy et al, 2013;Bektas-Kayhan et al, 2014) Human Papillomavirus (HPV), an epitheliotropic DNA virus, is known to be an etiologic agent in the tumorigenesis of cervical cancers. However, unlike cervical cancer, oral cancers are not widely accepted as a completely HPV associated malignancy.…”

The frequency of head and neck cancers among samples received by Ali-ibn Abi Talib Hospital Pathology Centre from 2005 to 2016, Rafsanjan, Iran

“…In addition, the most common site of involvement was the skin of the head and neck in the southeast of Iran (9). In most articles, skin cancers are not considered in the category of head and neck cancers, so the larynx was reported as the most common site of involvement in Kerman (46.76%) (10); in the same vein, Mafi et al reported laryngeal cancer as the most common type of head and neck cancers in both sexes in Iran (11). In the present study, the second most common site of involvement was thyroid after skin, probably due to the referral of laryngeal cancer to another medical center.…”