Browse > Article
http://dx.doi.org/10.7314/APJCP.2013.14.9.5061

Early Stage Oral Tongue Cancer among Non-Tobacco Users - An Increasing Trend Observed in a South Indian Patient Population Presenting at a Single Centre  

Krishnamurthy, Arvind (Cancer Institute (WIA))
Ramshankar, Vijayalakshmi (Cancer Institute (WIA))
Publication Information
Asian Pacific Journal of Cancer Prevention / v.14, no.9, 2013 , pp. 5061-5065 More about this Journal
Abstract
Background: Oral tongue squamous cell carcinoma (OTSCC) is the most common cancer diagnosed within the oral cavity worldwide. Many studies in India report OTSCC ranking among the top two most common subsites within the oral cavity. India is often labeled the oral cancer capital of the world. The incidence of tongue cancers in the population-based cancer registry (PBCR) of Chennai is showing an increasing trend. A majority of the oral cavity cancers (85%) in our cancer center present in advanced stages (III and IV). In contrast, early tongue cancers (stages I and II) constitute nearly 45% of all OTSCCs. Aim: The aim of this study was to analyze the clinical profile and epidemiological trends in our early stage tongue cancer patients with an emphasis on tobacco and alcohol habits. Materials and Methods: This retrospective analysis was based on a prospectively collected database of 458 consecutive early stage OTSCC in-patients at a tertiary care oncology centre in Chennai between 1995 and 2008. Results: Our study suggests that the earlier trends have clearly changed whereby nearly half of our patients are now never-tobacco users. The findings of the study indicate that a majority of the patients were never alcohol users (86.4%) and nearly half of them were never tobacco users (49.3%), and they had the best survival outcomes. This increasing trend of OTSCC among non-tobacco users is in contrast to our earlier experience of tongue cancer more than five decades ago.The median age of patients in our study was 53.3 years; the male to female ratio was approximately 2:1. The median follow up for the 458 patients was 53 months. Conclusions: Our study importantly as well as interestingly shows a conspicuous absence of association with the traditional risk factors, tobacco and alcohol.
Keywords
Oral tongue cancer; tobacco chewers; never smokers; alcohol; overall survival;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Silverman S Jr (2001). Demographics and occurrence of oral and pharyngeal cancers. The outcomes, the trends, the challenge. J Am Dent Assoc, 132, 7-11.   DOI   ScienceOn
2 Soudry E, Preis M, Hod R, et al (2010). Squamous cell carcinoma of the oral tongue in patients younger than 30 years: clinicopathologic features and outcome. Clin Otolaryngol, 35, 307-12.   DOI   ScienceOn
3 Turati F, Garavello W, Tramacere I, et al (2010). A meta-analysis of alcohol drinking and oral and pharyngeal cancers. Part 2: results by subsites. Oral Oncol, 46, 720-6.   DOI   ScienceOn
4 Veness MJ, Morgan GJ, Sathiyaseelan Y, Gebski V (2003). Anterior tongue cancer: age is not a predictor of outcome and should not alter treatment. Anz J Surg, 73, 899-904.   DOI   ScienceOn
5 Vijayalakshmi R, Krishnamurthy A (2012). Human papilloma virus in head and neck cancers? Role and relevance in clinical management. Indian J Surg Oncol, 12, 196-205.
6 Wallner PE, Hanks GE, Kramer S, McLean CJ (1986). Patterns of Care study: analysis of outcome survey data: anterior two thirds of tongue and floor of mouth. Am J Clin Oncol, 9, 50-7.   DOI
7 Warnakulasuriya S. (2009) Global epidemiology of oral and oropharyngeal cancer. Oral Oncol, 45, 309-16.   DOI   ScienceOn
8 Warnakulasuriya S (2009). Causes of oral cancer-an appraisal of controversies. Bri Dent J, 207, 471-5.   DOI   ScienceOn
9 Zheng Y, Kirita T, Kurumatani N, Sugimura M, Yonemasu K (1999). Trends in oral cancer mortality in Japan: 1950-1993. Oral Dis, 5, 3-9.
10 Andre K, Schraub S, Mercier M, Bontemps P (1995) Role of alcohol and tobacco in the aetiology of head and neck cancer: a case-control study in the Doubs region of France. Eur J Cancer B Oral Oncol, 31, 301-9.   DOI   ScienceOn
11 Annertz K, Anderson H, Biorklund A, et al (2002). Incidence and survival of squamous cell carcinoma of the tongue in Scandinavia, with special reference to young adults. Int J Cancer, 101, 95-9.   DOI   ScienceOn
12 Bachar G, Hod R, Goldstein DP, et al (2011) Outcome of oral tongue squamous cell carcinoma in patients with and without known risk factors. Oral Oncol, 47, 45-50.   DOI   ScienceOn
13 Davidson BJ, Root WA, Trock BJ (2001). Age and survival from squamous cell carcinoma of the oral tongue. Head Neck, 23, 273-9.   DOI   ScienceOn
14 Dickman PW, Hakulinen T, Luostarinen T, et al (1999). Survival of cancer patients in Finland 1955-1994. Acta Oncol, 38, 1-103.   DOI   ScienceOn
15 El-Husseiny G, Kandil A, Jamshed A, et al (2000) Squamous cell carcinoma of the oral tongue: an analysis of prognostic factors. Bri J Oral Maxillofac Surg, 38, 193-9.   DOI   ScienceOn
16 Elango JK, Gangadharan P, Sumithra S, Kuriakose MA (2006). Trends of head and neck cancer in urban and rural population. Asian Pac J Cancer Prev, 7, 108-12.
17 Friedlander PL, Schantz SP, Shaha AR, Yu G, Shah JP (1998). Squamous cell carcinoma of the tongue in young patients: a matched-pair analysis. Head Neck, 20, 363-8.   DOI
18 Iype EM, Pandey M, Mathew A, et al (2001). Oral cancer among patients under the age of 35 years. J Postgrad Med, 47, 171.
19 Gupta PC, Murti PR, Bhonsle RB, Mehta FS, Pindborg JJ (1995). Effect of cessation of tobacco use on the incidence of oral mucosal lesion in a 10 yr follow-up study of 12,212 users. Oral Dis, 1, 54-8.
20 Hyam DM, Conway RC, Sathiyaseelan Y, et al (2003). Tongue cancer: do patients younger than 40 do worse? Aust Dent J, 48, 50-4.   DOI   ScienceOn
21 Kantola S, Parikka M, Jokinen K, et al (2000). Prognostic factors in tongue cancer - relative importance of demographic, clinical and histopathological factors. Bri J Cancer, 83, 614-9.   DOI   ScienceOn
22 Llewellyn CD, Johnson NW, Warnakulasuriya (2001). Risk Factors for squamous cell carcinoma of the oral cavity in young people - a comprehensive literature review. Oral Oncology, 37, 401-18.   DOI   ScienceOn
23 Liao CT, Wang HM, Hsieh LL, et al (2006). Higher distant failure in young age tongue cancer patients. Oral Oncol, 42, 718-25.   DOI   ScienceOn
24 Patel SC, Carpenter WR, Tyree S, et al (2011). Increasing incidence of oral tongue squamous cell carcinoma in young white women, age 18 to 44 years. J Clin Oncol, 10, 1488-94.
25 Manuel S, Raghavan SK, Pandey M, Sebastian P (2003). Survival in patients under 45 years with squamous cell carcinoma of the oral tongue. Int J Oral Maxillofac Surg, 32, 167-73.   DOI   ScienceOn
26 Mathew Iype E, Pandey M, Mathew A, et al (2001). Squamous cell carcinoma of the tongue among young Indian adults. Neoplasia, 3, 273-7.   DOI
27 Moore SR, Johnson NW, Pierce AM, Wilson DF (2000). The epidemiology of tongue cancer: a review of global incidence. Oral Dis, 6, 75-84.
28 Rao DN, Desai PB (1998). Risk assessment of tobacco, alcohol and diet in cancers of base tongue and oral tongue--a case control study. Indian J Cancer, 35, 65-72.
29 Pitman KT, Johnson JT, Wagner RL, Myers EN (2000) Cancer of the tongue in patients less than forty. Head Neck, 22, 297-302.   DOI
30 Polesel J, Talamini R, La Vecchia C, et al (2008). Tobacco smoking and the risk of upper aero-digestive tract cancers: a reanalysis of case-control studies using spline models. Int J Cancer, 122, 2398-402.   DOI   ScienceOn
31 Sankaranarayan R (1990). Oral cancer in India, an epidemiologic and clinical review. Oral Surg Oral Med Oral Pathol, 69, 325-30.   DOI   ScienceOn
32 Sarkaria JN, Harari PM (1994). Oral tongue cancer in young adults less than 40 years of age: rationale for aggressive therapy. Head Neck, 16, 107-11.   DOI   ScienceOn
33 Schmidt BL, Dierks EJ, Homer L, Potter B (2004). Tobacco smoking history and presentation of oral squamous cell carcinoma. J Oral Maxillofac Surg, 62, 1055-8.   DOI   ScienceOn
34 Siegelmann-Danieli N, Hanlon A, Ridge JA, et al (1998). Oral tongue cancer in patients less than 45 years old: institutional experience and comparison with older patients. J Clin Oncol, 16, 745-53.   DOI
35 Shanta V, Krishnamurthi S (1959). A study of aetiological factors in oral squamous cell carcinoma. Bri J Cancer, 13, 381-8.   DOI
36 Shanta V, Krishnamurthi S (1974). A preliminary report on the epidemiological study of oral cancer in South India. J Indian Dent Assoc, 1, 43-54.
37 Shiboski CH, Schmidt BL, Jordan RC (2005). Tongue and tonsil carcinoma: increasing trends in the US population ages 20-44 years. Cancer, 103, 1843-9.   DOI   ScienceOn
38 Garavello W, Spreafico R, Gaini RM (2007). Oral tongue cancer in young patients: a matched analysis. Oral Oncol, 43, 894-7.   DOI   ScienceOn