- Volume 14 Issue 9
DOI QR Code
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))
- Published : 2013.09.30
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.
Oral tongue cancer;tobacco chewers;never smokers;alcohol;overall survival
- 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. https://doi.org/10.1016/0964-1955(95)00041-0
- 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. https://doi.org/10.1002/ijc.10577
- 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. https://doi.org/10.1016/j.oraloncology.2010.11.003
- Davidson BJ, Root WA, Trock BJ (2001). Age and survival from squamous cell carcinoma of the oral tongue. Head Neck, 23, 273-9. https://doi.org/10.1002/hed.1030
- Dickman PW, Hakulinen T, Luostarinen T, et al (1999). Survival of cancer patients in Finland 1955-1994. Acta Oncol, 38, 1-103. https://doi.org/10.1080/028418699432996
- Garavello W, Spreafico R, Gaini RM (2007). Oral tongue cancer in young patients: a matched analysis. Oral Oncol, 43, 894-7. https://doi.org/10.1016/j.oraloncology.2006.10.013
- 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. https://doi.org/10.1054/bjom.1999.0235
- 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.
- 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. https://doi.org/10.1002/(SICI)1097-0347(199808)20:5<363::AID-HED1>3.0.CO;2-W
- 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.
- Hyam DM, Conway RC, Sathiyaseelan Y, et al (2003). Tongue cancer: do patients younger than 40 do worse? Aust Dent J, 48, 50-4. https://doi.org/10.1111/j.1834-7819.2003.tb00009.x
- Iype EM, Pandey M, Mathew A, et al (2001). Oral cancer among patients under the age of 35 years. J Postgrad Med, 47, 171.
- 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. https://doi.org/10.1054/bjoc.2000.1323
- 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. https://doi.org/10.1016/S1368-8375(00)00135-4
- Liao CT, Wang HM, Hsieh LL, et al (2006). Higher distant failure in young age tongue cancer patients. Oral Oncol, 42, 718-25. https://doi.org/10.1016/j.oraloncology.2005.11.012
- 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.
- 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. https://doi.org/10.1054/ijom.2002.0271
- Mathew Iype E, Pandey M, Mathew A, et al (2001). Squamous cell carcinoma of the tongue among young Indian adults. Neoplasia, 3, 273-7. https://doi.org/10.1038/sj.neo.7900172
- Moore SR, Johnson NW, Pierce AM, Wilson DF (2000). The epidemiology of tongue cancer: a review of global incidence. Oral Dis, 6, 75-84.
- Pitman KT, Johnson JT, Wagner RL, Myers EN (2000) Cancer of the tongue in patients less than forty. Head Neck, 22, 297-302. https://doi.org/10.1002/(SICI)1097-0347(200005)22:3<297::AID-HED14>3.0.CO;2-3
- 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. https://doi.org/10.1002/ijc.23385
- 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.
- Sankaranarayan R (1990). Oral cancer in India, an epidemiologic and clinical review. Oral Surg Oral Med Oral Pathol, 69, 325-30. https://doi.org/10.1016/0030-4220(90)90294-3
- 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. https://doi.org/10.1002/hed.2880160202
- 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. https://doi.org/10.1016/j.joms.2004.03.010
- 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. https://doi.org/10.1200/JCO.19188.8.131.525
- Shanta V, Krishnamurthi S (1959). A study of aetiological factors in oral squamous cell carcinoma. Bri J Cancer, 13, 381-8. https://doi.org/10.1038/bjc.1959.43
- 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.
- 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. https://doi.org/10.1002/cncr.20998
- 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. https://doi.org/10.14219/jada.archive.2001.0382
- 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. https://doi.org/10.1111/j.1749-4486.2010.02164.x
- 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. https://doi.org/10.1016/j.oraloncology.2010.07.010
- 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. https://doi.org/10.1046/j.1445-2197.2003.02818.x
- 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.
- 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. https://doi.org/10.1097/00000421-198602000-00013
- Warnakulasuriya S. (2009) Global epidemiology of oral and oropharyngeal cancer. Oral Oncol, 45, 309-16. https://doi.org/10.1016/j.oraloncology.2008.06.002
- Warnakulasuriya S (2009). Causes of oral cancer-an appraisal of controversies. Bri Dent J, 207, 471-5. https://doi.org/10.1038/sj.bdj.2009.1009
- 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.
- Tongue carcinoma infrequently harbor common actionable genetic alterations vol.14, pp.1, 2014, https://doi.org/10.1186/1471-2407-14-679
- A Model Approach to Calculate Cancer Prevalence from 5 Years Survival Data for Selected Cancer Sites in India - Part II vol.15, pp.14, 2014, https://doi.org/10.7314/APJCP.2014.15.14.5681
- Demographic Risk Factors, Affected Anatomical Sites and Clinicopathological Profile for Oral Squamous Cell Carcinoma in a North Indian Population vol.15, pp.16, 2014, https://doi.org/10.7314/APJCP.2014.15.16.6755
- Profile and Survival of Tongue Cancer Patients in "Dharmais" Cancer Hospital, Jakarta vol.15, pp.5, 2014, https://doi.org/10.7314/APJCP.2014.15.5.1971
- Carcinoma of the Tongue: A Case-control Study on Etiologic Factors and Dental Trauma vol.15, pp.5, 2014, https://doi.org/10.7314/APJCP.2014.15.5.2225
- Characteristics of Oral Tongue and Base of the Tongue Cancer: A Hospital Cancer Registry Based Analysis vol.16, pp.4, 2015, https://doi.org/10.7314/APJCP.2015.16.4.1371
- Molecular Portrait of Oral Tongue Squamous Cell Carcinoma Shown by Integrative Meta-Analysis of Expression Profiles with Validations vol.11, pp.6, 2016, https://doi.org/10.1371/journal.pone.0156582
- p53 Expression Helps Identify High Risk Oral Tongue Premalignant Lesions and Correlates with Patterns of Invasive Tumour Front and Tumour Depth in Oral Tongue Squamous Cell Carcinoma Cases vol.17, pp.1, 2016, https://doi.org/10.7314/APJCP.2016.17.1.189
- Human papilloma virus (HPV) infection leads to the development of head and neck lesions but offers better prognosis in malignant Indian patients vol.206, pp.3, 2017, https://doi.org/10.1007/s00430-017-0502-5
- Operable Oral Tongue Squamous Cell Cancer: 15 Years Experience at a Tertiary Care Center in North India pp.0976-6952, 2017, https://doi.org/10.1007/s13193-017-0658-x
- Advanced-stage tongue and mouth floor cancer is related to tobacco and alcohol abuse pp.1613-2238, 2017, https://doi.org/10.1007/s10389-017-0859-3
- Global Quantitative Proteomics reveal Deregulation of Cytoskeletal and Apoptotic Signalling Proteins in Oral Tongue Squamous Cell Carcinoma vol.8, pp.1, 2018, https://doi.org/10.1038/s41598-018-19937-3
- variants along with HPV infection in oral cancer among the prolonged tobacco-chewers vol.40, pp.8, 2018, https://doi.org/10.1177/1010428318793023