Abstract
Objective:The associated risk factors for the majority of patients with head and neck squamous cell carcinoma (HNSCC) are tobacco and betel nut abuse, while there also seems to be a rising proportion of patients who report no history of tobacco or betel nut usage. Therefore, objective of the study was to find out potential risk factors and demographics of HNSCC patients addicted to tobacco and/or betel nut, as well as non-addicted patients.Methods:This epidemiological study was conducted in Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, and Jinnah Postgraduate Medical Centre (JPMC) from January to December 2016. All subjects were participants in an epidemiological study of HNSCC. Demographics and clinical characteristics were obtained for 185 addicted and 26 non-addicted patients.Results:Non-addicted patients were more likely to be females (χ2=19.0, p<0.001) and were significantly younger than addicted patients (χ2=21.0, p<0.001). Addicted patients more likely belonged to a lower income group (χ2=14.4, p=0.006) and had a higher proportion of oral cancers (χ2=30.0, p<0.001). Almost all addicted females had oral cancers (97%), whereas more than half of the non-addicted females had oral cancers (53%).Conclusions:Addicted patients commonly have oral cavity cancers. This might be due to the habit of chewing tobacco and/or betel nut that addicted patients have. Non-addicted patients are commonly young females. It is likely that no single known factor is responsible for HNSCC in non-addicted patients, and several occupational exposure studies in future may be important to the etiology of non-addicted patients.
Highlights
The annual incidence of head and neck cancers is more than 650,000 cases worldwide with approximately 330,000 deaths per year.[1]
This study was approved by the Institutional Review Board (IRB) at the Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi (KIBGE/ICE/003/2015 Nov. 25, 2015), and Jinnah Postgraduate Medical Centre Karachi
To define the demographics and potential risk factors for head and neck squamous cell carcinoma (HNSCC) in tobacco and/ or betel nut addicted and non-addicted patients, a total of 211 HNSCC diagnosed patients were included in this study
Summary
The annual incidence of head and neck cancers is more than 650,000 cases worldwide with approximately 330,000 deaths per year.[1] Around 90% of all head and neck cancers are squamous cell carcinoma, known as head and neck squamous cell carcinoma (HNSCC).[2] HNSCC is the sixth most common cancer worldwide,[3] but the second most common cancer in Pakistan.[4] HNSCC is associated with various lifestyle and environmental risk factors. HNSCC has been strongly associated with tobacco use, the risk for HNSCC in habitual. Pak J Med Sci November - December 2019 Vol 35 No 6 www.pjms.org.pk 1712 tobacco users is almost ten times higher than that in non-tobacco users. Almost 70-80% of HNSCC diagnoses are associated with tobacco and alcohol use.[5]
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