1. Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma.
- Author
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Barsouk A, Aluru JS, Rawla P, Saginala K, and Barsouk A
- Subjects
- Male, Female, Humans, Adolescent, Child, Squamous Cell Carcinoma of Head and Neck complications, Risk Factors, Carcinoma, Squamous Cell epidemiology, Carcinoma, Squamous Cell prevention & control, Carcinoma, Squamous Cell etiology, Head and Neck Neoplasms epidemiology, Head and Neck Neoplasms prevention & control, Head and Neck Neoplasms complications, Papillomavirus Infections complications, Papillomavirus Infections epidemiology, Papillomavirus Infections prevention & control
- Abstract
Head and neck squamous cell carcinoma (HNSCC) is a group of malignancies, involving the oral cavity, pharynx, hypopharynx, larynx, nasal cavity, and salivary glands, that together compose the seventh most common cancer diagnosis worldwide. With 890,000 new cases and 450,000 deaths annually per GLOBOCAN estimates, HNSCC accounts for roughly 4.5% of cancer diagnoses and deaths. In the developing world, the incidence of HNSCC is growing with increasing consumption of tobacco (smoked or chewed), alcohol, and areca nut (betel quid). Alcohol and tobacco have a synergistic effect, with the heavy consumption of both increasing HNSCC risk 40-fold. In developed nations, HPV-related HNSCC surpasses tobacco- and alcohol-related disease. HPV-related HNSCC more commonly affects the oropharynx, hypopharynx, and larynx than the oral cavity, and is associated with a significantly longer median survival (130 months vs. 20 months). Discrepancies in etiology as well as disparities in lifestyle choices and access to healthcare may account for the greater incidence and poorer survival of HNSCC among minority and lower-socioeconomic-status communities in developed nations. Pharmacotherapy and counseling together have been shown to be effective in promoting smoking and alcohol cessation. Education on cancer risk and community engagement have reduced areca nut consumption in Asia as well as in diaspora communities. HPV vaccination, starting at age 11-12 for both sexes, has been shown to reduce the prevalence of high-risk HPV serologies and prevent pre-cancerous lesions of the cervix, vagina, and vulva. As of 2020, 58.6% of eligible adolescents in the US have received the full two-vaccine series. Increased adoption of vaccination, education on safe sex practices, and routine visual oral screening for high-risk patients would curb growing HNSCC incidence in developed nations.
- Published
- 2023
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