Oral Tongue Cancer Increasing

In Young, White Females

A UNC study released this week in the "Journal
of Clinical Oncology" finds an increasing incidence
of squamous cell carcinoma of the oral tongue in
young white females in the United States over the
last three decades.

A team of researchers from UNC Lineberger
Comprehensive Cancer Center analyzed data from
the National Cancer Institute's Surveillance, Epidemiology
and End Results (SEER) database and found that, between
1975 and 2007, the overall incidence for all ages, genders,
and races of the disease was decreasing. However, the
incidence of oral tongue squamous cell carcinoma rose
28 percent among individuals ages 18 to 44. Specifically,
among white individuals ages 18 to 44 the incidence
increased 67 percent. The increasing incidence was
most dramatic for white females ages 18 to 44. They
had a percentage change of 111 percent. Interestingly,
the incidence decreased for African American and other
racial groups.

Historically, oral tongue cancer has been strongly
associated with heavy tobacco and alcohol use. Other
epidemiological studies have related the decreasing
incidence of oral tongue cancer in the United States to
the decreased use of tobacco products. Though the UNC
research team verified the known decreasing incidence of
oral tongue cancer, they were surprised to observe an
increasing incidence in young white individuals, specifically
young white females.

"Lately we have been seeing more oral tongue cancer
in young white women in our clinic. So we looked at the
literature, which reported an increase in oral tongue
squamous cell carcinoma in young white individuals
but couldn't find any information about gender-specific
incidence rates, so we decided we should take a look
at the SEER data," said researchers conducting the the
study from the Department of Radiation Oncology.

Over the past decade an association between the
human papilloma virus with squamous cell carcinoma
of the tonsil and tongue has been observed. Patients
with human papilloma virus associated oral squamous
cell carcinoma are typically male, white, non-smokers,
non-drinkers, younger in age and have higher
socioeconomic status.

The researchers at UNC have preliminarily tested the
cancers of the oral tongue of their young white female
patients and have not found them to be associated with
the virus. Other institutions have also noted the absence
of the virus in young females with oral tongue cancer.
The UNC researchers have also anecdotally observed
that these young white female patients are typically
non-smokers and non-drinkers.

"Our findings suggest that the epidemiology of this
cancer in young white females may be unique and that
the causative factors may be things other than tobacco
and alcohol abuse. Based on our observations and the
published data, it appears that these cases may not be
associated with the human papilloma virus. We are
actively researching other causes of this cancer in this
patient population." they explained.

Though the increasing rate of oral tongue cancer in
young white females is alarming oral tongue cancer is
a rare cancer, relative to breast, lung, prostate, and
colorectal cancer. "Primary care physicians and dentist
should be aware of this increasing incidence and screen
patients appropriately," the researchers emphasize. Oral
tongue cancer is typically treated with surgery first
followed by radiation and, in some cases, chemotherapy.

Other UNC Lineberger researchers who contributed to
the study include Sagar Patel, BA, of the Department
of Radiation Oncology, William R. Carpenter, PhD, MHA,
professor of health policy and management in the UNC
Gillings School of Global Public Health, Marion Couch, MD,
PhD, formerly a professor of otolaryngology/head & neck
surgery at UNC (now at the University of Vermont), Mark
Weissler, MD, distinguished professor of otolaryngology/
head & neck surgery, Trevor Hackman, MD, assistant
professor of otolaryngology/head & neck surgery, D. Neil
Hayes, MD, MPH, associate professor in the division of
hematology/oncology, and Carol Shores, MD, PhD,
associate professor of otolaryngology/head & neck
surgery.

Story Source:

University of North Carolina School of Medicine

Journal Reference:

Increasing Incidence of Oral Tongue Squamous Cell Carcinoma in Young White Women, Age 18 to 44 Years. Journal of Clinical Oncology, 2011;

Editor's Note: This article is not intended to provide medical advice,

diagnosis or treatment.

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