Cavity Cancer Research Articles

Factors associated with baseline quality of life in patients with oral cavity and oropharyngeal cancer.

e18079 Background: Baseline quality of life (QOL) predicts for survival in head and neck cancer patients. The purpose of this study was to identify factors contributing to baseline QOL in patients with newly diagnosed oral cavity or oropharyngeal cancer (OCOPC) in order to identify potential targets for intervention. Methods: 115 patients with OCOPC completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, Hospital Anxiety and Depression Scale, and Brief Health Literacy Screen (BHLS). Pearson correlation and ANOVA statistics were used to analyze the data. Results: The median global health-related QOL score was 66.7 (IQR: 50, 83.4); 35.7% of participants reported anxiety and 18.3% reported depressive symptoms (HADS ≥8); 30.8% of patients had BHLS values of ≤ 9. Factors associated with significant decrease in global health-related QOL score: household income of < $20,000/year (p = .010); low health literacy (p = .021); having symptoms of anxiety (p < .001); having depressive symptoms (p < .001); and non-HPV associated cancer (p < .001). Increased tumor stage, older age, single/widowed marital status, and unemployment were associated with the lower scores on the physical QOL subscale (p < .05). Increased tumor stage was associated with lower scores on role and social QOL subscales (p < .05), and younger age was associated with lower scores on emotional QOL subscale (p < .05). Conclusions: Baseline QOL is associated with socioeconomic and disease-related determinants. Clinical trial information: NCT02412241.

Epidemiological, clinical and aetiological aspects of otalgia at the Renaissance University Hospital

BackgroundOtalgia is a frequent reason for medical consultation. In Africa, few studies have been devoted to the epidemiology and aetiology of otalgia. To our knowledge, no study has been carried out in Chad.AimsThe objective of this study is to describe the epidemiological, clinical and aetiological aspects of otalgia in Chadian hospitals.MethodsThis was a prospective, descriptive and analytical study conducted at the Renaissance University Hospital from January to August 2020. All the patients that were consulting in the ENT department for otalgia were included. Data was analysed using SPSS version 26. The chi-square test was used to compare the results.Results88 (22.3%) of the 395 patients suffered from otalgia. Their sex ratio was 1:1 (M:F). Their average age was 30.4 ± 19.5 years. The median age was 31.5 years with extremes from 1 to 70 years. Children (1–18 years) represented 30.7% of the cases. The average time of consultation was 27.8 ± 35.0 days. Otalgia was associated with deafness in 33% of the cases and 29.5% of the patients have used cotton swabs. Otogenic otalgia in 73.9% of the cases was significantly more frequent in children (92.6% versus 65.6%, P =0.008). Otogenic otalgia was related to otitis externa, chronic otitis media and Eustachian tube dysfunction in 44.6%, 21.5%, and 13.9% of cases respectively. The aetiologies of the referred otalgias were angina and rhinopharyngitis (30.4%), trigeminal neuralgia (21.7%) and oral cavity, pharyngeal and laryngeal cancer (21.7%).ConclusionOtalgia is a frequent reason for medical consultation at any age regardless of sex. However, ear infections are more frequent in children. Referred otalgias predominate in adults, dominated by pharyngeal infections, trigeminal neuralgia and oral cavity, pharyngeal and laryngeal cancers.

Developing a Biosensor-Based Immunoassay to Detect HPV E6 Oncoprotein in the Saliva Rinse Fluid of Oral Cancer Patients.

Transmission of Human papillomavirus (HPVs) is faithfully associated with carcinogenesis of oral cavity and oropharyngeal cancers. Therefore, clinical researchers may need to generate customized antibodies for the upcoming ELISA-based analysis to discover rare but valuable biomarkers. The aim of study was to develop and generate a biosensor-based immunoassay for early screening HPV-related oral cancer via saliva rinse fluid analysis. A peptide fragment of high-risk HPV subtype 16/18 protein, E6 protein (HP-1 protein sequence 48–66), was designed and synthesized, followed by the generation of polyclonal antibodies (anti-HP1 IgY) in our university-based laboratories. The titer and specificity of antibodies were determined by enzyme-linked immunosorbent assay (ELISA), and the Surface Plasmon Resonance (SPR) biosensor-based method was developed. Kinetic analyses by SPR confirmed that this designed peptide showed a high affinity with its generated polyclonal antibodies. Saliva fluid samples of thirty oral cancer patients and 13 healthy subjects were analyzed. SPR indicated that 26.8% of oral cancer patients had higher resonance unit (ΔRU) values than normal subjects. In conclusion, we developed a biosensor-based immunoassay to detect HPV E6 oncoprotein in the saliva rinse fluid for early screening and discrimination of HPV-related oral cancer patients.

Comparison of Oral Cavity and Oropharynx Cancer Patients Presentation at Regional Cancer Center: An Observational Study

Comparison of Oral Cavity and Oropharynx Cancer Patients Presentation at Regional Cancer Center: An Observational Study

Prevalence of Human Papillomavirus in the Oropharynx of Healthy Individuals in an Italian Population.

Oral cavity and oropharynx cancer associated with human papil loma virus infection, particularly in young people who are continuously exposed to this virus, is a serious public health problem worldwide, especially for high-risk strains that are most associated with premalignant lesions and tumors. These neoplasms remain asymptomatic for a long time and, when they occur, they are already at an advanced stage. If diagnosed and treated early, oral cancer induced by human papilloma virus allows for high survival, as it often has a more favorable prognosis than oral cancers not directly related to viral infection. In this study, the presence of different high-risk and low-risk HPV strains was investigated to assess the epidemiological status in a population of healthy individuals. Two types of samples, one from the tonsils and one from the base of the tongue, were collected from 2015 healthy individuals of different sex and age. A total of 1885 DNA samples belonging to 1285 patients were tested for the presence of 11 high-risk HPV types plus 4 low-risk HPV types using real-time PCR. Of the patients’ DNA samples screened for 15 HPV types, only four samples were positive, all of which were taken from male smokers. These results indicate that newly acquired oral oncogenic HPV infections in the healthy population are rare and, in many cases, controversial. Therefore, more studies are needed to ensure fewer variations in outcomes and a greater clarification of HPV infection and its prevalence in the oropharynx of the healthy population, and to guide efforts to prevent the development of this infection which, if undiagnosed, can lead to the onset of malignant tumors in the oral cavity.

Extranodal extension influences prognosis in pancreatic head cancer.

593 Background: Extranodal extension (ENE) is an established prognostic factor of several gastrointestinal cancers; furthermore, ENE is already included as one component of nodal category of oral cavity, penis, and vulvar cancers. However, the prognostic impact of ENE in pancreatic cancer remains unclear. In this study, we aimed to investigate prognostic implication of ENE in patients with surgically resected pancreatic cancer. Methods: We retrospectively reviewed electronic medical records and pathologic slides of 503 surgically resected pancreatic head cancer patients, who consecutively underwent pancreaticoduodenectomy for pathologically confirmed pancreatic ductal adenocarcinoma between January 2009 and December 2013. Patients were categorized into subgroups according to ENE status and AJCC 8th pancreatic cancer staging system. We compared the disease-free survival rates of the patients according to ENE status. Cox proportional hazard analysis was performed to evaluate prognostic factors for the disease-free survival of pancreatic head cancer. Results: ENE-positive patient group showed a larger tumor size, a higher rate of lymph node metastasis, and a tendency to be positive for lymphovascular invasion, perineural invasion, and resection margin (p < 0.001). Patients with ENE had lower overall survival (OS) and disease-free survival (DFS) rates compared with those without ENE (N0, 30 months; LN+/ENE-, 20 months; LN+/ENE+, 16 months; p < 0.001), (N0, 13 months; LN+/ENE-, 8 months; LN+/ENE+, 5 months; p < 0.001). Patients with higher N categories had lower OS and DFS rates. In addition, even in the same N stage, patients with ENE showed lower OS and DFS rates than those without ENE (p < 0.001). However, there was no significant difference in survival rates between patients in the N1/ENE+ group and the N2/ENE- group. Additionally, ENE was an independent prognostic factor for pancreatic cancer. Conclusions: ENE significantly influenced adverse prognosis among patients with pancreatic head cancer especially for those with nodal metastasis. Therefore, ENE should be considered as a prognostic factor in the future editions of the AJCC staging system.

Estimating LOCP cancer mortality rates in small domains in Spain using its relationship with lung cancer

The distribution of lip, oral cavity, and pharynx (LOCP) cancer mortality rates in small domains (defined as the combination of province, age group, and gender) remains unknown in Spain. As many of the LOCP risk factors are preventable, specific prevention programmes could be implemented but this requires a clear specification of the target population. This paper provides an in-depth description of LOCP mortality rates by province, age group and gender, giving a complete overview of the disease. This study also presents a methodological challenge. As the number of LOCP cancer cases in small domains (province, age groups and gender) is scarce, univariate spatial models do not provide reliable results or are even impossible to fit. In view of the close link between LOCP and lung cancer, we consider analyzing them jointly by using shared component models. These models allow information-borrowing among diseases, ultimately providing the analysis of cancer sites with few cases at a very disaggregated level. Results show that males have higher mortality rates than females and these rates increase with age. Regions located in the north of Spain show the highest LOCP cancer mortality rates.

Probable Change of Sleep Parameters after Resection and Reconstruction Surgeries in Patients with Oral Cavity or Oropharyngeal Cancers.

In patients of oral cavity or oropharyngeal cancers, resection of the tumor and reconstruction of the defect may reduce the framework, add a bulky flap, alter the tissue flexibility, and contribute to postoperative obstructive sleep apnea (OSA). Postoperative OSA and the potential consequences may decrease the survival rate and reduce patients' quality of life. It is unclear whether the surgery is associated with postoperative OSA. Here, we compared the polysomnographies (PSGs) before and after the surgery in 15 patients of oral cavity or oropharyngeal cancers (out of 68 patients of head and neck cancers) without a chemo- or radio-therapy. Each patient received the second PSG before the start of any indicated adjuvant therapy to prevent its interference. There were 14 men and 1 woman, with a mean age and a standard deviation (SD, same in the following) of 56.2 ± 12.8 years. There were 6 tongue cancers, 5 buccal cancers, 2 tonsil cancer, 1 lower gum cancer, and 1 trigone cancer. The results show that the surgery changed sleep parameters insignificantly in apnea-hypopnea index (AHI), mean oxyhemoglobin saturation of pulse oximetry (SpO2), minimum SpO2, mean desaturation, and desaturation index but increased mean heart rate in the patients with free flaps. These results hint that the effect of surgery on developing OSA was small in this sample, with a longer plate or a larger framework for a bulkier free flap. It needs future studies with a large sample size to generalize this first observation.

Age-specific lip, oral cavity and pharynx cancer incidence rate in the world

Age-specific lip, oral cavity and pharynx cancer incidence rate in the world

The role of genetic polymorphisms in endolysosomal ion channels TPC2 and P2RX4 in cancer pathogenesis, prognosis, and diagnosis: a genetic association in the UK Biobank

Recent studies have implicated important roles for endolysosomal ion channels in cancer biology. We used UK Biobank data to characterise the relationships between genetic variants in two genes coding for endolysosomal ion channels—i.e. TPCN2 and P2RX4—and cancer in terms of the definition of tumour types, susceptibility, and prognosis. We investigated these relationships at both global and local levels with regard to specific types of cancer, including malignant neoplasms of the brain, breast, bronchus, lung, colon, lymphoid and haematopoietic systems, skin, ovary, prostate, rectum, thyroid gland, lip, oral cavity, pharynx, and urinary tract. Apart from rs3829241 (p value < 0.05), all the genetic variants were in Hardy–Weinberg equilibrium. We included 468,436 subjects in the analysis and stratified them into two major cohorts: cancer-free controls (385,253) and cancer cases (83,183). For the first time, we report novel associations between genetic variants of TPCN2 and P2RX4 and cancer/cancer subtypes in the UK Biobank’s population. Genotype GG in TPCN2 rs3750965 was significantly associated with a decreased risk of cancer and an increased risk of lip, oral cavity, and pharynx cancer and cancer recurrence in patients with prostate cancer, and genotypes GA/GG were associated with a significantly lower risk of developing various malignant neoplasms (involving melanoma, prostate, mesothelial, and soft tissues). rs35264875:TA was associated with a high risk of cancer at the global level, with subtypes of cancer at the local level (including breast, colon, prostate, and stated or presumed primary cancer of lymphoid, haematopoietic, and related tissue), and with a significantly low risk of cancer metastasis. rs72932540:GA was associated with a higher incidence of cancer/cancer subtypes (including breast, melanoma, and rectal cancer), and genotypes GA/GG were associated with an increased risk of prostate cancer. The P2RX4 rs25644 allele GG was associated with a high risk of prostate cancer, whereas it was associated with a low risk of cancer recurrence in patients with prostate cancer. Genotypes GA/GG in rs28360472 were associated with an increased risk of breast, mesothelial, and soft tissue cancers but with a decreased risk of colon cancer. We also provide insights into the pathophysiological contributions made by these significant polymorphisms to cancer/cancer subtypes and their effects on expression or channel activity. Further investigations of these genetic variants could help identify novel cancer biomarkers and facilitate the development of new diagnostic and therapeutic strategies. This would constitute a further step towards personalised cancer care.

Genetic and Proteinic Linkage of MAO and COMT with Oral Potentially Malignant Disorders and Cancers of the Oral Cavity and Pharynx

Simple SummaryThe prevention and treatment of cancers of the oral cavity and pharynx are currently important issues for national health. Currently, the incidence of oral cavity and pharynx cancers is globally the highest in Taiwanese men. Regarding the occurrence of oral cavity and pharynx cancers and oral potentially malignant disorders (OPMD), no report has ascertained how betel quid (BQ) can induce the expression of monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT). We aimed to explore the role and clinical significance of specific markers of BQ exposure and human susceptibility to MAO and COMT. Our findings highlight the association of MAO and COMT biomarkers to risks of oral and pharyngeal cancers and OPMD. These novel findings will provide important strategies for disease prevention, early clinical diagnosis, and treatment effectiveness, and will offer a strong foundation to reduce BQ-related cancers of the oral cavity and pharynx and OPMD.Betel quid (BQ), a group I human carcinogen, strongly contributes to an increased risk of oral potentially malignant disorders (OPMD) and cancers of the oral cavity and pharynx. This study was conducted to discover whether monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT) variants play a potential role in the risk assessment of oral cavity and pharynx cancers and OPMD, particularly among BQ users. We applied a case–control study to confirm the polymorphism of MAO and COMT using single-nucleotide polymorphisms. We used qRT-PCR, Western blotting, and immunohistochemistry (IHC) to determine MAO and COMT expression. Carriers of the MAOA rs6323 G-allele, MAOB rs6324 G-allele, and COMT rs4633 C/C-genotype had a prominently increased risk of oral cavity and pharynx cancers (AOR = 56.99; p < 0.001). Compared to adjacent noncancerous tissues, a significant downregulation of MAO and COMT expression was exhibited in cancerous tissues (p < 0.01). Furthermore, in different cell models, MAO and COMT expression was significantly downregulated with an increased dose of arecoline (p < 0.01). In personalized preventive medicine for oral and pharyngeal cancers, our findings are the first to demonstrate the potential role of lower MAO and COMT expression levels, with the risk polymorphisms utilized as clinical biomarkers.

MODERN APPROACHES TO THE ORBITAL WALL RECONSTRUCTION WITH TITANIUM NICKELIDE IMPLANTS IN PATIENTS WITH NASAL CAVITY AND PARANASAL SINUS CANCER

Background. The majority of tumors of the nasal cavity and paranasal sinus are diagnosed at an advanced stage, requiring invasive and mutilating surgery, and therefore, the reconstruction of post-surgical craniofacial bone defects using various implants is necessary.Purpose of the study: to evaluate the effectiveness of the use of the thin-profile implants made of titanium nickelide in the surgical treatment of nasal cavity and paranasal sinus cancers.Material and Methods. From 2002 to 2020, a total of 60 patients with stage Т3–4n0–1M0 nasal cavity and paranasal sinus cancer were treated at the Cancer Research institute (tomsk). All patients received radiation therapy followed by surgery with reconstruction of bone structures of the subcranial region and orbital walls. In the study group (n=30), the orbital walls were restored with individual thin-profile shape memory titanium nickelide implants. In the control group (n=30), typical porous and tissue titanium nickelide implants were used. They required adjustment during surgery and complicated reparative processes in the postoperative period due to their thickness. Tissue implants did not allow accurate restoration of the orbital walls due to their structure.Results. Surgical rehabilitation with orbital wall reconstruction using thin-profile titanium nickelide implants makes it possible to shorten the duration of surgery and improve the precision of surgical repair. Features of the architectonics of implants do not interfere with the growth of tissues of the recipient zone, thus preventing the development of inflammation in the implantation site. The technique allows adequate restoration of the natural position and function of the eye.

Disparate survival of late-stage male oropharyngeal cancer in Appalachia

The United States Appalachian region harbors a higher cancer burden than the rest of the nation, with disparate incidence of head and neck squamous cell carcinomas (HNSCC), including oral cavity and pharynx (OC/P) cancers. Whether elevated HNSCC incidence generates survival disparities within Appalachia is unknown. To address this, HNSCC survival data for 259,737 tumors from the North American Association for Central Cancer Registries 2007–2013 cohort were evaluated, with age-adjusted relative survival (RS) calculated based on staging, race, sex, and Appalachian residence. Tobacco use, a primary HNSCC risk factor, was evaluated through the Behavioral Risk Factor Surveillance System from Appalachian states. Decreased OC/P RS was found in stage IV Appalachian white males within a subset of states. The survival disparity was confined to human papillomavirus (HPV)-associated oropharyngeal cancers, specifically the oropharynx subsite. This correlated with significantly higher smoking and male smokeless tobacco use in most Appalachian disparity states. Lower survival of Appalachian males with advanced-stage HPV-associated oropharyngeal cancers suggests pervasive tobacco consumption likely generates more aggressive tumors at HPV-associated oropharynx subsites than national averages. Comprehensive tobacco and HPV status should therefore be evaluated prior to considering treatment de-intensification regimens for HPV-associated oropharyngeal cancers in populations with high tobacco consumption.

Abstract B129: Does insurance status explain the racial disparity in survival outcome seen in upper aerodigestive tract cancers in the United States?

Abstract Upper Aerodigestive tract (UADT) cancers are primarily squamous cell carcinomas that affect the oral cavity (hard palate, front 2/3 of tongue, gums, mucosal lining of lips and cheeks, and the floor of the mouth), oropharynx (base of the tongue, soft palate, and tonsils), hypopharynx, larynx (epiglottis and vocal cords), and the upper third of the esophagus with a five-year survival rate of 65.3% for oral cavity and pharyngeal cancers. If the cancer is detected during the localized stage, the survival rate improves to 84.4% (SEER 18 2009-2015).There have been several risk factors implicated in the pathogenesis of UADT cancers such as, male gender, smoking, alcohol use, and infection with human papilloma virus (HPV) for oropharyngeal cancers. The current literature suggests that regardless of stage people of African descent have a lower incidence of UADT cancers, but higher mortality rates compared to Caucasians. There are many proposed explanations for this paradoxical trend seen in African Americans. However, there is a paucity of research addressing this problem. We seek to understand if socioeconomic status is the underlying factor driving this disparity. We analyzed de-identified data collected from the Surveillance, Epidemiology, and End Results (SEER) program for 114,510 UADT cancer patients diagnosed from 2007-2016. We hypothesized that people who were uninsured or on Medicaid would have a life expectancy that was significantly reduced compared to those that had private insurance or Medicare regardless of race, tumor grade, gender or site of the cancer. Our study design is retrospective cohort. Our multivariate analysis model utilizes survival analysis techniques such as Kaplan-Meier survival, hazard curves and proportional hazards regression to analyze the survival time of our patients as a function of demographic and clinical variables. Survival months ranged from 0 to 119 months, with 25,122 patients experiencing death due to UADT cancers. The proportional hazards regression revealed that across all insurance groups (Insured, Uninsured, Medicaid, and Unknown) the survival time for Non-Hispanic Black People was significantly reduced compared to the other race/ethnicities (Asians, Caucasians, Hispanics (all races)) with Non-Hispanic Caucasians having the highest survival rate. Determining that the racial disparity exists regardless of insurance status, tumor grade, gender, and site of cancer can guide future researchers to focus on biological differences or other factors such as lack of access to care that underlie disease survival for UADT cancers. Citation Format: Joycemary G Amponsem, Dana Marshall, Derek Wilus, Mohammad Tabatabai. Does insurance status explain the racial disparity in survival outcome seen in upper aerodigestive tract cancers in the United States? [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B129.

Incidence trends of squamous cell carcinoma of the head and neck (SCCHN) in the aging population: A SEER based analysis from 2000-2016.

e18522 Background: SCCHN is more prevalent in the elderly. As the United States population ages, it is increasingly important to evaluate the change in the incidence of SCCHN in this population. Methods: This was a retrospective study using data from a population-based cancer registry (Surveillance, Epidemiology, and End Results) to identify patients ≥65 years old with the diagnosis of SCCHN between the years 2000-2016. The subgroups of oral cavity (OCC)and oropharynx cancer (OPC) were also analyzed independently. The incidence per year was calculated and joinpoint detection was used to identity significant changes in incidence trends. Annual percent change (APC) was detected to determine if the incidence trend was statistically significant. The study population was further stratified by sex. Results: For all sites, a joinpoint was found in 2003 with a statistically significant decrease in APC in incidence for males from 2000-2003 of -2.45%. For OCC, there was a joinpoint in 2005 with a statistically significant increase in APC in incidence for male patients of 1.41%. For (OPC), no joinpoint was found, but there was a statistically significant increase in APC in incidence for males of 3.41%. For females no joinpoint was found, but for OCC there was a statistically significant decrease in APC in incidence of -0.40%. Conclusions: In patients ≥ 65 years old the trend in incidence rate for all SCCHN sites stratified by sex has decreased between 2000-2016. However, for males the annual percent change in incidence has increased for OCC from 2005-2016 and for OPC from 2000-2016. [Table: see text]

Determining the unmet survivorship needs in patients with head and neck cancer: A prospective, longitudinal study.

e24088 Background: Head and neck cancer patients commonly have unmet needs. Our purpose was to determine the number, type, and predictors of unmet survivorship needs in patients with head and neck cancer over their cancer journey. Methods: Patients with primary, non-metastatic head and neck cancer were prospectively enrolled prior to curative intent treatment (surgery, radiation and or systemic therapy in any combination). Patients completed baseline demographics, the Cancer Survivors' Unmet Needs Measure (CaSUN) and the FACT-HN and then again 3, and 6 months post-treatment. Mean unmet needs at each time point were calculated. Univariable and stepwise multivariable analyses of predictors for number of unmet needs were performed at each time point. Results: Among 187 participants, median age was 64 (31-88) and 148 (79%) were male. Education was beyond high school in 117 (63%) and 63 (41%) were working at diagnosis. Most patients had oropharynx (n = 84; 46%), hypopharynx/larynx (n = 40; 22%) or oral cavity (n = 28;15%) cancers. At least one unmet need was reported by 68%, 52%, and 56% at baseline, 3 and 6 months. The mean number of unmet needs was 7.5 ± 9.1 at baseline, 3.8 ± 6 at 3 months and 5.4 ± 8.5 at 6 months. Higher education level [3.24 (0.24,6.24); p = 0.035] and worse QOL [-0.14 (-0.22,-0.06); p &lt; 0.01] were associated with increased survivorship unmet needs on multivariable analysis at baseline. Worse QOL was associated with increased survivorship unmet needs on multivariable analysis at 3 [-0.21 (-0.31,-0.12); p &lt; 0.01] and 6 months [-0.27 (-0.49,-0.06); p &lt; 0.01]. Table describes the top unmet needs. Conclusions: A high proportion of patients with head and neck cancer have unmet needs, more commonly in patients with poorer quality of life. Post-treatment, unmet needs were more often related to treatment toxicities and their impact on quality of life. [Table: see text]

Epidemiology of head and neck cancers: an update.

This review attempts to give an update of epidemiological knowledge on head and neck cancers (HNC). Worldwide, from 1990 to 2017, incidence rates for larynx and nasopharyngeal cancers decreased, whereas they increased for oro/hypopharyngeal cancers and lip/oral cavity cancers. They are still markedly higher among men than women. South Asia has the highest HNC incidence rate, followed by Europe, North America, and Australasia.Tobacco and alcohol remain the major risk factors. Rate of cancers attributable to human papillomavirus (HPV) among HNCs is highly depending on world region and tobacco use prevalence. It increases in high-income countries. In the US population, the number of HPV-attributable oropharyngeal cancers now exceeds the number of cervix cancers. HPV vaccination for boys is recommended in an increasing number of countries. Many occupations are associated with an increased HNC risk. Fruits and vegetables intake have a protective effect against HNC. To decrease HNC incidence, measures to reduce tobacco use and alcohol consumption remain essential. Improvement of HPV vaccination coverage is also a major objective. Reduction of carcinogens at occupation, protection of workers from carcinogen exposures, education for better diet, and easy and affordable access to fruits and vegetables can contribute to incidence decrease.

Assessment of the gustatory function in patients with advanced oral cavity and oropharyngeal cancer.

The changes in gustatory function resulting from oncological treatment occur mainly after radiotherapy. However, the head and neck tumors, because of the anatomical location of the lesion, can themselves trigger significant changes in the feeding-related functions - including taste. To assess the gustatory function in patients diagnosed with advanced oral cavity and oropharyngeal cancer. This descriptive cross-sectional study comprised 31 individuals with advanced oral cavity and oropharyngeal cancer, referred for oncological treatment with radiotherapy, either alone or in combination with chemotherapy. The "taste strips" test was applied; it consists of inserting solutions with four different concentrations each for salty, sweet, and sour tastes, and three concentrations for the bitter taste, on the tongue. Most of the individuals were diagnosed with oropharyngeal cancer. Approximately half of the sample already had taste-related complaints, and more than 80%, swallowing-related complaints. The overall frequency of hypogeusia was 38.7%, in which the bitter taste stood out in its isolated assessment. The association of change in gustatory function proved to be significant in patients in stage T4. The decrease in gustatory function in individuals with oral cavity and oropharyngeal cancer was evidenced in this study, especially when associated with tumors in stage T4. Regarding feeding, most of them reported complaints of dysphagia, suggesting the importance of the speech-language-hearing assessment and follow-up, even before the oncological treatment, to minimize the risks of dysphagia.

56 Nutritional Risk Index in Patients Undergoing Chemoradiation Therapy for Oral Cavity and Oropharynx Cancer

56 Nutritional Risk Index in Patients Undergoing Chemoradiation Therapy for Oral Cavity and Oropharynx Cancer

Abstract 643: Poor oral hygiene is associated with HPV-negative and not HPV-positive oral cancer

Abstract Background Oral health and hygiene have been implicated as risk factors for oral squamous cell carcinoma (i.e. oral cavity and oropharyngeal cancers, OSCC), and we recently reported that these risk factors also dramatically alter the oral microbiome. Here we performed a more detailed analysis of associations between oral health behaviors and OSCC in a matched case-control study. We stratified our analysis to compare and contrast associations with Human Papillomavirus (HPV)-positive versus HPV-negative OSCC. Methods Cases were patients with newly diagnosed OSCC at The Ohio State University Comprehensive Cancer Center between 2011 and 2014. Controls were patients without cancer from the same outpatient clinic who were matched (2:1) to each case on age, sex, and race. Cases were stratified by tumor high-risk HPV status (HPV-positive, n=117; HPV-negative, n=114) based on E6 or E7 mRNA expression. Data on demographics; tobacco, alcohol, and sexual history; and oral health behaviors were collected using an audio computer-assisted self-interview. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI), and oral health behaviors significant in univariable analysis were evaluated in separate multivariable models. Results In univariable analysis, oral health behaviors such as low frequency of dental clinic visit, tooth brushing, and dental flossing; gum bleeding; tooth loss; and denture use significantly increased risk of HPV-negative OSCC, whereas none of these behaviors increased risk of HPV-positive OSCC. In univariable analysis, covariates associated with increased risk of HPV-negative OSCC were low education and income level, high lifetime tobacco pack-years (0, &amp;gt;0-&amp;lt;20, ≥20-&amp;lt;40, &amp;gt;40) and high lifetime heavy (≥14 drinks/week) drinking years (0, &amp;gt;0-&amp;lt;10, ≥10-&amp;lt;20, ≥20). In contrast, covariates associated with increased risk of HPV-positive OSCC were low education level, high lifetime marijuana use years (0, &amp;gt;0-&amp;lt;10, ≥10-&amp;lt;20, ≥20) and high no. of oral sex partners (0-2, 3-6, ≥7). After adjusting for covariates in multivariable analysis, a frequency of less than once per year dental clinic visits significantly increased risk of HPV-negative OSCC (OR = 2.28 [95% CI = 1.14-4.57]). Dental flossing less than once per day also increased risk of HPV-negative OSCC, overall (OR = 3.56 [95% CI = 1.04-12.14]) and in those without denture (OR = 4.34 [95% CI = 1.07-17.63]). In multivariable analysis, frequency of tooth brushing and gum bleeding, denture use, and tooth loss were not associated with HPV-negative OSCC. Conclusion Poor oral health behaviors such as infrequent dental visits and dental flossing were independently associated with HPV-negative OSCC, but not with HPV-positive OSCC. These findings are consistent with a hypothesis that poor oral health behaviors alter oral microbial composition to promote chronic inflammation and the development of HPV-negative OSCC. Citation Format: Jitesh B. Shewale, Robert Pickard, Maura L. Gillison. Poor oral hygiene is associated with HPV-negative and not HPV-positive oral cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 643.