Increasing Incidence of Oral Tongue Squamous Cell Carcinoma in Young White Women, Age 18 to 44 Years

Patel, Sachin; Carpenter, William R.; Tyree, Seth; Couch, Marion E.; Weissler, Mark C.; Hackman, Trevor; Hayes, D. Neil; Shores, Carol G.; Chera, Bhishamjit S.

doi:10.1200/jco.2010.31.7883

Cited by 339 publications

(436 citation statements)

References 27 publications

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“…Most diagnosed patients in this study were between 51 and 70 years old (53.9%), which is in accordance with the literature (3,9,16,19) indicating that age is probably a risk marker for OSCC (16). However, Patel et al (6) showed an increased incidence among white female young individuals, aged 18 to 44 years, postulating that there may be a new and emerging head and neck cancer population.…”

Section: Discussionsupporting

confidence: 80%

“…However, in recent decades, there has been an increasing trend of OSCC development in females and young adults, for whom other etiological factors like genetic heritage, dietary habits and Human Papilomavirus (HPV) infection have been pointed out as causes (5)(6)(7). It has been observed that environmental and cultural differences may be closely related to the average occurrence of OSCC.…”

Section: Introductionmentioning

confidence: 99%

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Demographic and Clinical Profile of Oral Squamous Cell Carcinoma from a Service-Based Population

et al. 2017

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The aim of this study was to evaluate the demographic and clinical profile of the oral squamous cells carcinoma (OSCC) cases registered in a center of oral diagnosis in southern Brazil. Eight hundred and six individuals with OSCC from 1959 to 2012 were included in this study. The variables recorded were: sex, age, occupation according to workplace, alcohol and tobacco consumption, skin color, tumor location, histological type, clinical appearance, size, evolution time, presence of pain and lymph node metastasis. Descriptive analysis was performed and the associations between variables were assessed using the chi-square and Fisher's exact test, with a confidence level of 5%. OSSC was more common in males (76.6%) aged between 51 to 70 years (53.9%). The most frequent sites were lower lip vermilion (23.3%), tongue (20.2%) and gingiva/alveolar ridge (18.1%). There was a strong association between outdoor occupation and white skin color with lip squamous cell carcinoma (LSCC). OSCC intraoral lesions were commonly more painful, larger than 2 cm and presented lymphatic metastasis. In conclusion, most of the results confirm the data from literature about sex, age, tumor location and occupation. Moreover, the positive correlations between LSCC and occupation, between LSCC and white skin color, and between bigger lesions and presence of pain/cervical metastasis also corroborate the literature data.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Demographic and Clinical Profile of Oral Squamous Cell Carcinoma from a Service-Based Population

et al. 2017

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“…1 However, rates of cancers of the oral tongue, base of tongue, and palatine tonsils have continued to rise by 2-4% among younger men. 2,3 This may, in part, be explained by the increased prevalence of a subset of oropharyngeal carcinoma associated with human papillomavirus (HPV), mostly HPV-16. [4][5][6][7] Importantly, p16 overexpression is noted in almost all HPV-associated head and neck cancers and indicates that the virus is transcriptionally active.…”

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confidence: 99%

Human papillomavirus-associated oral intraepithelial neoplasia

2013

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This study evaluated an unusual subset of oral epithelial dysplasia for the presence of transcriptionally active high-risk HPV subtypes and to further characterize the histological criteria for this condition. There were 20 cases diagnosed as epithelial dysplasia with marked apoptosis of the anterior oral cavity. Clinical and followup data were collected and histopathological features were documented. Immunoperoxidase studies were performed for p16 and in situ hybridization studies were performed for low-and high-risk HPV sub-types. Gender-and site-matched controls of conventional moderate-to-severe oral epithelial dysplasia were similarly evaluated using immunoperoxidase studies for p16 and in situ hybridization; the number of apoptotic cells for study and control cases was counted at two different tissue sites. There were 17 men and 3 women with a median age of 56 years. Seventeen lesions were described as white and five were described as rough or papillary. Thirteen were located on the lateral or ventral tongue, some extending onto the floor of the mouth. Epithelial hyperplasia with marked karyorrhexis and apoptosis were present in all the cases, along with features of conventional oral epithelial dysplasia. A statistically significant number of apoptotic cells were identified in the study cases when compared with controls (P40.0001). Twenty cases were positive for high-risk HPV by in situ hybridization and all 19 nineteen cases evaluated for p16 demonstrated overexpression. Two patients were diagnosed with squamous cell carcinomas and one patient developed recurrent disease. We report a subset of oral epithelial dysplasia that occurs mostly in adult men on the ventral or lateral tongue and is positive for high-risk HPV and for p16. We propose use of the term 'HPV-associated Oral Intraepithelial Neoplasia' to characterize these lesions of the oral cavity for consistency in nomenclature with HPV-associated lesions of the lower anogenital tract. One case recurred and one developed invasive cancer. Keywords: HPV apoptotic oral epithelial dysplasia; koilocytic dysplasiaIn the United States, smoking frequency has decreased by 16% and the overall number of cases of cancer of the oral cavity and pharynx has fallen by 18% since 1975. 1 However, rates of cancers of the oral tongue, base of tongue, and palatine tonsils have continued to rise by 2-4% among younger men. 2,3 This may, in part, be explained by the increased prevalence of a subset of oropharyngeal carcinoma associated with human papillomavirus (HPV), mostly HPV-16. 4-7 Importantly, p16 overexpression is noted in almost all HPV-associated head and neck cancers and indicates that the virus is transcriptionally active. Patients with HPV-positive, p16-positive oropharyngeal carcinomas are slightly younger than those with tumors not associated with HPV and show improved survival. 8,9 It is generally believed that HPV has only a minor role in squamous cell carcinoma of the anterior oral cavity, because it has been identified in only 2.9-5.9% of cases and the beha...

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“…Several studies have shown a high rate of occult nodal metastasis (20-40%) in tongue SCC patients with no evidence of regional spread on clinical or radiographic evaluation (8,(10)(11)(12)(13)(14)(15). There is a tendency that tongue cancer increases in young females in recent 2-3 decades (16)(17)(18). Thus, metastasis suppression is a main and urgent subject in the treatments of patients with tongue SCC.…”

Section: Introductionmentioning

confidence: 99%

Enhancement of active MMP release and invasive activity of lymph node metastatic tongue cancer cells by elevated signaling via the TNF-α-TNFR1-NF-κB pathway and a possible involvement of angiopoietin-like 4 in lung metastasis

Tanaka

Imamura

Yoneda

et al. 2016

International Journal of Oncology

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Abstract.To study the role of TNF-α in tongue cancer metastasis, we made highly metastatic cells from a human oral squamous cell carcinoma cell line (SAS) by repeating the passage in which the cells were injected into a nude mouse tongue and harvested from metastasized cervical lymph nodes. Cancer cells after 5 passages (GSAS/N5) increased invasive activity 7-fold in a TNF-α receptor 1 (TNFR1)-dependent manner and enhanced mRNA expression of TNF-α and TNFR1. In the highly metastatic cells, NF-κB activation was upregulated via elevated phosphorylation of Akt and Ikkα/β in the signaling pathway and secretion of TNF-α, active MMP-2 and MMP-9 increased. Suppression of increase of TNF-α mRNA expression and MMP secretion by NF-κB inhibitor NBD peptide suggested a positive feedback loop in GSAS/N5 cells; TNF-α activates NF-κB and activated NF-κB induces further TNF-α secretion, leading to increase of active MMP release and promotion of invasion and metastasis of the cells. GSAS/N5 cells that had been injected into the nude mouse tongue and harvested from metastasized lungs multiplied angiopoietin-like 4 (Angptl4) expression with enhanced migration activity, which indicated a possible involvement of Angptl4 in lung metastasis of the cells. These results suggest that TNF-α and Angptl4 promote metastasis of the oral cancer cells, thus, these molecules may be therapeutic targets for patients with tongue cancer. IntroductionThe American Cancer Society estimated 45,780 new cases of oral cavity and pharyngeal cancer, and 8,650 deaths from these tumors, in 2015 in the United States (1). By advances in surgery and radiation therapy, the 5-year survival rate for oropharyngeal cancer has increased to 66%, but the rate is still unsatisfactory in comparison with some other site cancers including prostate, thyroid and breast; the rates of these types of cancer are >90% (1). A primary cause for the unfavorable prognosis is patient death from the cancer metastasized at regional and distant sites (2-5). Squamous cell carcinoma (SCC) accounts for approximately 90% of oral and oropharyngeal malignancies in the United States and tongue is a common site of the malignant diseases (6,7). The rate of nodal metastasis is higher in tongue cancer patients than oral cavity cancer patients whose rate is 30% on their initial evaluation (8,9). Several studies have shown a high rate of occult nodal metastasis (20-40%) in tongue SCC patients with no evidence of regional spread on clinical or radiographic evaluation (8,10-15). There is a tendency that tongue cancer increases in young females in recent 2-3 decades (16-18). Thus, metastasis suppression is a main and urgent subject in the treatments of patients with tongue SCC.The process of metastasis is complex and involves tumor growth, the extra-cellular matrix breakdown, invasion to the vessels, escape from immune surveillance, transport to other sites with adhesion to the vessel, subsequent invasion into an organ where tumor cells proliferate, grow and spread. Various molecules participate in the pr...

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Increasing Incidence of Oral Tongue Squamous Cell Carcinoma in Young White Women, Age 18 to 44 Years

Abstract: OTSCC is increasing among young white individuals age 18 to 44 years, particularly among white women. Young white women may be a new, emerging head and neck cancer patient population.

Cited by 339 publications

References 27 publications

Demographic and Clinical Profile of Oral Squamous Cell Carcinoma from a Service-Based Population

Demographic and Clinical Profile of Oral Squamous Cell Carcinoma from a Service-Based Population

Human papillomavirus-associated oral intraepithelial neoplasia

Enhancement of active MMP release and invasive activity of lymph node metastatic tongue cancer cells by elevated signaling via the TNF-α-TNFR1-NF-κB pathway and a possible involvement of angiopoietin-like 4 in lung metastasis

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