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1.
BACKGROUND: Successful initial treatment of oral and oro-phayngeal cancer has led to the emergence of second primary tumours (SPTs). Population data are meagre. METHODS: Occurrence of multiple primary cancers following a malignancy in a head and neck site was computed using data from a population-based cancer registry covering a population of 14 million. RESULTS: Among 59,958 subjects reported to the registry, 5.5% males and 3.6% females developed a second primary cancer. At the sites studied, a total of 2771 second primary cancers were found, compared with an expected number of 2341. The standardised incidence ratio (SIR) for contracting a new primary cancer was 1.14 (95% CI=1.09-1.19) for men and 1.34 (95% CI=1.24-1.44) for women. There was a significantly increased risk for a second cancer in most of the upper aerodigestive tract sites that are generally regarded as tobacco associated, with an SIR for subsequent oral cancer of 5.56 in men and 15.31 in women. Subjects first detected with a pharyngeal cancer experienced the highest SIR for a subsequent tumour. Excluding tobacco-associated sites, the risk of a subsequent cancer was not significantly raised in either sex (SIR 0.87 (95% CI 0.81-0.93) for men; SIR 0.99 (95% CI 0.90-1.09) for women). CONCLUSIONS: The relative risk for multiple primary cancer was higher in younger subjects, those detected with a head and neck cancer during the 1990s as compared with earlier decades of the study, and among patients who received radiotherapy for their first tumour. By 20 years from the time of the first head and neck cancer, we estimate that approximately 30% of male patients and 20% of female patients will have developed an SPT.  相似文献   

2.
Social status and occupation-specific risks of cancers of the lip, tongue, mouth and pharynx were studied in a nationwide series of 2369 men and 809 women diagnosed in Finland in 1971–1985 and recorded in the files of the Finnish Cancer Registry. Codes for social status (four classes) and occupation (336 categories) were drawn from the files of the 1970 Population Census. The standardised incidence rates (SIR) were defined as the ratios of observed and expected numbers of cases, the expected ones being based on the sex, age, site and calendar period-specific incidence rates in the Finnish population. The SIR of lip cancer in the lowest social class was five times that of the highest one, thus indicating the effects of social class differences in smoking habits. The effect of outdoor work on the development of lip cancer was also strongly supported by this study. The social class-adjusted SIR for fishermen was 2.7 (95% C.I. 1.3–5.0), for forestry managers 2.2 (1.2–3.6), for timber workers 1.9 (1.2-2.9) and for farmers 1.8 (1.2-2.6). For cancers of the oral cavity and pharynx there was no clear correlation with social class. However, the SIR for these cancers among farmers was significantly reduced. The occupation-specific SIRs pointed more to alcohol than smoking aetiology. In the case of cancer of the tongue, no aetiological clues whatsoever could be found. The role of direct occupational factors in the aetiology of any of these cancers seemed to be minimal.  相似文献   

3.
Abstract The standardized morbidity ratios (SMR) of lip and non-melanomatous skin cancer (basal-cell carcinoma excluded) of the head and neck in males were determined for different Occupational groups in Finland. The data on all cases of these types of cancer diagnosed in Finland in the age group 35–69 years in 1971–75 were supplemented by information on occupations from the 1970 census (Central Statistical Office of Finland). The expected numbers of cases were based on the age and occupation-specific numbers of person-years computed by the Central Statistical Office, and the age-specific incidence rates of lip and skin cancers among the economically active population. The highest SMR of lip cancer among all the occupational groups was found in agriculture, forestry and fishing (1.64). In contrast, the SMR of skin cancer was not higher than expected in occupations related to agriculture and forestry. Significantly lower than expected risks of lip cancer were observed among highly educated while-collar workers, among whom the risk of contracting skin cancer was the highest (technical, scientific, humanistic and artistic work, SMR 1.78). The morbidity of both lip and skin cancers varies considerably by occupation, and tin-risks seem to be, at least in part, inversely related. Thus, it is probable that there are also differences in the risk factors, contrary to several earlier suggestions. The nature of these factors are discussed.  相似文献   

4.
We examined the relationship between a family history of cancer and risk of roal and pharyngeal cancer using epidemiological data from a large case-control investigation of these tumours. 487 (45.7%) of the cases and 485 (41.0%) of the controls reported cancer in a parent or a sibling. After controlling for age, race, sex, study location, respondent status and smoking and alcohol use, the OR associated with any cancer in the family was 1.1 [95% confidence interval (CI) 0.9–1.3]. Risks were non-significantly elevated among those with a history of cancers arising from the oral cavity/pharynx (OR = 1.2, 95% CI 0.7–2.3), oesophagus/larynx (OR = 1.6, 95% CI 0.7–3.8) and lung (OR = 1.2, 95% CI 0.8–1.8), with the excess risk primarily among those for whom a male relative, particularly a brother, was affected with these smoking-related cancers. In addition, an elevated risk of oral/pharynx cancer was found among those whose sisters developed other cancers (OR = 1.6, 95% CI 1.1–2.2). Subsite analyses revealed stronger elevated risks of smoking-related cancers in relatives of pharyngeal cancer cases (OR = 1.7, 95% CI 1.1–2.8) than of oral cancer patients. The data indicate that there is at most a weak familial aggregation of oral/pharynx cancers. Furthermore, since the excess familial risk of oral/pharynx cancer was associated with smoking-related cancers among male but not female relatives, it seems likely that environmental factors (notably smoking and drinking) contribute to the familial tendency observed in this study. The results underscore the need to collect risk profile information on relatives in future studies to disentangle genetic from environmental determinants.  相似文献   

5.
A survey was made of second primary cancers among patients who were enrolled in a large case-control investigation of oral and pharyngeal cancer, hereafter called oral cancer, during 1984–1985 in four areas of the United States. Among the original 1090 patients with oral cancer (nearly all squamous cell carcinomas), 107 developed a second cancer (one-half of them squamous cell) by the end of follow-up in June 1989 (average follow-up 2.6 years), with 69% occurring in the oral cavity, pharynx, oesophagus, larynx or lung. Rates of second tumours varied by age and socioeconomic status, but not sex or race, and were higher among those whose initial cancer was localised, even after adjusting for their longer survival. Long-term survival was lower among those with second cancers. Conditional on surviving for 2 years, the survival at 5 years was under 50% and nearly 70%, respectively, for those with versus those without a second cancer in the first 2 years. These findings confirm the exceptionally high rate of second cancers (especially of the aerodigestive tract) following oral cancer, describe the clinical and pathological features of patients with multiple cancers and indicate the importance of preventive measures.  相似文献   

6.
This study analyzed characteristics of oral cancer patients from Tehran, Iran, and their tumors. Data came from the patient records of 30 major hospitals in Tehran. Patients (n = 1042), diagnosed with invasive oral cancer in 1993-2003, were classified by primary tumor site according to ICD-10 (C00-C10). Data were analyzed separately for lip, oral cavity and salivary gland tumors. Statistical evaluation included chi and t-test. Of all cases, 59% were male. Age for all cases ranged from 6-103 years, mean age was 58.8 years (SD 16; median 62); 89% were older than 40. Tumor site breakdown was 65% oral cavity, 21% major salivary glands and 14% lip. A clear gender difference (P < 0.001) appeared regarding the primary tumor sites: women dominated in oral cavity cancers and men in lip cancers. The most common cancer site was the tongue (32%), accounting for 50% of the oral cavity cancers. Histologically, 88% of all oral cavity and lip cancers were squamous cell carcinomas, 10% of those were in age /= age 65. At the time of diagnosis, 59% of oral cavity cancers and 29% of lip cancers were at stage III or IV (P < 0.001). The results emphasize an urgent need for a national program focusing on early detection of oral cancers, including educational information addressed to oral health professionals.  相似文献   

7.
BACKGROUND: Mucous membrane pemphigoid is an autoimmune mucocutaneous blistering disease. A subset, known as anti-epiligrin cicatricial pemphigoid is associated with a high risk for malignancy. Oral pemphigoid (OP) is limited to the oral cavity. The purpose of this study was to determine the association between malignancy and patients with OP with antibodies to alpha6-integrin subunit. METHODS: We determined the incidence of cancer in 72 patients with OP and compared it to the expected incidence using age and sex-specific rates of malignancy in the National Cancer Institute's Surveillance, Epidemiology, and End Results (NCI SEER) Registry. RESULTS: During a mean observation period of 9.1 years (range: 2.8-40), for 70, three OP patients developed malignancies. The expected number of cancers based on the NCI SEER Registry was 8.83. The relative risk for cancer in OP patients, with autoantibodies to alpha6-integrin, was 0.34 (95% CI, 0.07-0.99, P < 0.05). CONCLUSION: It appears that patients with OP, with antibodies to alpha6, may have a possible reduced relative risk for developing cancer.  相似文献   

8.
Improved diagnostic techniques and more effective treatment concepts have resulted in a growing number of patients with oropharyngeal cancer diagnosed with second primary tumours. In order to evaluate the relative number of patients with second primary tumours and to estimate the efficacy of diagnostic procedures, a retrospective evaluation of 981 patients with oropharyngeal cancer, who were treated during 20 years in one single medical centre, was performed. In total, 9.2% of the patients were affected by secondary cancer, 1.5% from tertiary cancer and 0.2% from quartary cancer. Of the multiple cancers, 27.8% occurred synchronously and 72.2% metachronously. If the index tumour was located at the oral floor or the pharynx, the risk of second primary tumours was enhanced; if the index tumour was located at the lips or the tongue, the risk was reduced. The 5-year survival of all examined patients was 34.1%; the survival of patients with multiple cancers was 62.3% at the diagnosis of the index tumour and dropped to 30.5% at the diagnosis of an additional malignancy. Of the second primary tumours, 23.2% were diagnosed by panendoscopy. We conclude that among patients with oropharyngeal cancer, the presence of second primary tumours always has to be considered and that panendoscopy is a valuable tool for their diagnosis.  相似文献   

9.
A population-based survey was conducted in 35 municipalities in Northern Finland to assess the incidence of lip cancer as well as the patient and tumour characteristics in cases diagnosed between 1983 and 1997. A total of 96 new patients emerged. The age-standardised incidence (per 100,000 years) of lip cancer in men decreased from 4.8 in 1983-1987 to 1.4 in 1993-1997. The incidences in women were 0.30 to 0.36, respectively. The median age of the patients increased from 66 to 73 years through the years. Overall, 90% of the patients had at least one of the known risk factors, namely rural domicile, outdoor occupation or smoking. The median duration of symptoms also remained the same, as did the median size and location of the tumour at diagnosis. In contrast, spread to regional lymph nodes became rare during the period.  相似文献   

10.
11.
OBJECTIVE: The aim of this study was to describe the occurrence of oral and pharyngeal cancer in Finland over the last half century. MATERIALS AND METHODS: The study included all lip, oral and pharyngeal cancer cases diagnosed in Finland and reported to the nation-wide Finnish Cancer Registry between 1953 and 1999. RESULTS: The study comprised 17,383 new cancer cases: 11,666 in males and 5717 in females. Of these, 83% were squamous cell carcinomas. By the end of the study, 1999, the mean age at diagnosis had increased to 63 years for males and 67 for females. The age-adjusted incidence of oral and pharyngeal cancer decreased in males from 12.5 per 10(5) to 8.4 per 10(5) while it increased in females from 3.0 per 10(5) to 3.9 per 10(5). This was because of a decrease in lip cancer incidence in males, while the incidence of tongue, mouth and salivary gland cancers increased in both genders. The annual number of new oral cancer cases increased, however, in both genders. CONCLUSION: The incidence of lip cancer decreased in males, probably because of a decrease in smoking and in outdoor work. The incidence of intra-oral cancers increased in both genders, possibly because of increased alcohol consumption.  相似文献   

12.
Carcinoma of the lip is a common cancer of the head and neck area; its incidence is approximately one-quarter that for oral cavity cancers. It occurs most frequently on the lower lip of elderly males. This non-randomized Phase II study aimed to estimate the complete response (CR) rate to Foscan-mediated photodynamic therapy (Foscan-PDT) in patients with primary cancer of the lip, duration of CR, and the tolerability and safety of Foscan-PDT. Twenty-five patients with squamous cell carcinoma (SCC) of the lip (Tis, T1, T2/N0/M0) and Karnofsky status > or = 70 received 0.15 mg/kg Foscan intravenously, followed 4 days later by a single non-thermal illumination of the tumour (light dose 20 J/cm2, irradiance 100 mW/cm2, lambda=652 nm). Response was determined after 12 weeks and mean follow up is 424 days so far. After 12 weeks, 96% of cases (24/25) showed CR, and all CRs were confirmed by biopsy. The most common adverse event was swelling and local pain at the treatment site. Tumour recurrence was observed in two patients 4 and 18 months after PDT. One patient developed a single lymph node metastasis 7 months after therapy. Photosensitivity reactions occurred in five patients. The functional results were excellent in all patients without any signs of limited mouth opening or impaired lip closure. The cosmetic outcome was better than after surgical therapy. Foscan-PDT is an effective treatment modality for small primary tumours of the lips. Foscan-PDT yields complete response rates comparable to those published for surgery or radiotherapy without causing major toxicity. It allows preservation of form and function and does not compromise future treatment options for recurrent, residual or second primary disease.  相似文献   

13.
Trends in the incidence of oral cancer in Nova Scotia from 1983 to 1997   总被引:2,自引:0,他引:2  
OBJECTIVE: The purpose of the study was to characterize the total burden of oral cancer in Nova Scotia over the 15-year period from 1983 to 1997 and to identify any trends in the number of cases or incidence rates at specific anatomic sites or within specific age or sex groups over this time period. STUDY DESIGN: All cases that had a diagnosis of invasive oral cancer (ICD-9 sites 140-146) during the study period were retrieved from the records of the Nova Scotia Cancer Registry, which theoretically includes all cancer cases in the province. Cases of in situ carcinoma, lymphoma, and leukemia were not included. All cases during the study period were categorized by tumor site and the age and sex of the patient. Tumors at ICD-9 sites 141 and 143-146 were analyzed separately as intraoral cancer. Trends were studied by grouping cases into three 5-year periods: period 1 (1983-1987), period 2 (1988-1992), and period 3 (1993-1997). Age-standardized incidence rates were calculated to the 1991 Canadian standard population. RESULTS: A total of 1,155 cases of oral cancer were registered in Nova Scotia for this 15-year study period, accounting for 2.0% of all cancer cases. There was an average of 57 cases in men and 20 cases in women per year. Overall, the most common site was the lip (26% of cases), followed by the tongue (20%), other mouth (16%), tonsil/oropharynx (12%), salivary gland (12%), floor of mouth (10%), and gum (4%). About 5% of cases occurred in patients 40 years and younger, and 53% occurred in patients 65 years and older. Lip cancer in men decreased by 38%, and the age-standardized incidence rate fell from 5.6 to 3.0 per 100,000 from period 1 to period 3. Intraoral cancers in men increased by 23% and the age-standardized incidence rate increased by 10% from period 1 to period 3. Both measures peaked in period 2. Intraoral cancer in women increased steadily by 84%, and the age-standardized incidence rate increased by 48% from period 1 to 3. The male-to-female ratio for intraoral cancer cases decreased from 2.9 to 2.5 to 1.9 over the 3 periods. CONCLUSION: Although there was a decreasing trend for lip cancer, the number of cases and the age-standardized incidence rate for intraoral cancer increased over the 15-year study period. Intraoral cancer increases in females were dramatic. Trends in the number of cases reflected changing risk and a growing, aging population. More oral cancers occurred each year than cancers of the uterine cervix, suggesting the need for more resource allocation in the areas of research, prevention, and early detection of oral cancer.  相似文献   

14.
Age standardised oral cancer incidence rates were calculated for the Republic of Ireland from data collected by the Southern Tumour Registry for the years 1984–1988. The annual incidence rates (per 100 000) for men were lip 3.8, tongue 1.2 and mouth 1.8 while the corresponding rates for women were lip 0.2, tongue 0.7 and mouth 0.5. The incidence of lip cancer is shown to be much lower than indicated by previously published Irish rates. In general, oral cancer incidence rates in Ireland are comparable to those reported for Denmark. The vast majority (94%) of cases were histologically verified. The results, along with recent findings on mortality, contradict the view that Ireland has a very high rate of oral cancer by west European standards.  相似文献   

15.
目的:分析口腔颌面部多原发癌的发生时间、部位,诊断和治疗.方法:1993年1月至2004年12月在我院口腔颌面外科治疗的多原发癌患者9例,男性6例,女性3例,最小年龄49岁,最大年龄70岁,平均年龄60.4岁.8例作了根治性治疗,1例作了姑息性治疗.结果:9例均为异时癌,第二原发癌与第一原发癌平均间隔时间为:107.4个月.不同部位的多原发癌分别为:颊 软腭1例,舌 腭1例,鼻咽 口腔5例,口腔 颈下部1例,食道 口腔1例.组织学类型:鳞癌 鳞癌6例,恶性淋巴瘤 鳞癌2例,鳞癌 恶性黑色素瘤1例.二重癌8例,三重癌1例.结论:第一原发癌治疗后要长期密切随访,力争早期发现多原发癌,并注意与复发癌、转移癌鉴别,使多原发癌得到及时有效的治疗.  相似文献   

16.
OBJECTIVES: To estimate the burden and risk of oral cancer in Saudi Arabia and highlight differences between regions. METHODS: Using the National Cancer Registry Saudi Arabia, data was collated on numbers of cases of oral cancer (1996-1998) by site, age group, gender and region, plus relative frequencies of all cancer cases. Using Globocan, age-standardised rate (ASR) of oral cancer in Saudi Arabia was compared with five other neighbouring countries in the region. RESULTS: A total of 208 lip, mouth and tongue cancers for men and 209 for women were reported to the registry during this period. ASR of oral cancer was 1.81/100,000 for males and 2.13/100,000 for females. It was ranked 15th most common cancer for males and 11th for females, with a ratio of 1:1 and median age at diagnosis of 62 years. Very wide regional disparities in the incidence of oral cancer were found, with an almost thirty-fold difference in ASR between the regions with the lowest and highest rates. Jizan Region had the highest ASR (6.2/100,000 for males and 9.82/100,000 for females). Here oral cancer was ranked 2nd for males and 1st for females, with a ratio of 0.73:1 and the median age at diagnosis for females was lower. The third highest ASR (4.48/100,000) was found in females in Najran. In these two high incidence regions oral cancer was commonly reported on the gingiva. CONCLUSIONS: Overall the burden and risk of oral cancer in Saudi Arabia are not large. However, cancer of the oral cavity is a significant public health problem for the residents of Jizan and the women of Najran. Saudi females in both these regions have a higher burden of oral cancer.  相似文献   

17.
Congenital anomalies are caused by a variety of risk factors, including individual and environmental ones. This study estimated the prevalence of oral clefts and examined their area-level risk indicators using data from The National Congenital Anomaly Survey in South Korea. Disease mapping and ecological regression were used to assess the geographical variation and potential risk indicators for oral clefts, such as living in a rural area, material deprivation, and limited access to antenatal healthcare. In South Korea, 1.15 (95% CI, 1.08–1.23) children out of every 1,000 births were born with oral clefts during 2005 and 2006. The most common oral cleft type was cleft palate, followed by cleft lip, then cleft lip and palate. Disease mapping showed that the proportion of areas with a higher risk than the national average was relatively higher for oral clefts than for all congenital abnormalities among rural and healthcare underserved areas. The relative risk of oral cleft prevalence was higher in rural areas and healthcare underserved areas than in urban areas and areas with better access to healthcare. The findings suggest that access to antenatal healthcare as well as area-level risk indicators should be considered a priority when developing measures to decrease the occurrence of oral clefts.  相似文献   

18.
J Oral Pathol Med (2011) 40 : 684–692 Background: Recognition of how risk factors affect the age when cancers are first diagnosed may help to establish more appropriate cancer screening and preventive strategies. Methods: To investigate the independent and synergistic effects of alcohol, tobacco‐free betel‐quid (TF‐BQ), and cigarette use on diagnosis age and dissemination of upper aerodigestive tract squamous cell carcinoma (UADT‐SCC), we recruited pathology‐proven 1522 patients with UADT‐SCC for study. Results: A 49‐, 53‐, 57‐, and 62‐year‐old stepwise older median age at carcinoma diagnosis was, respectively, found among patients with oral, pharyngeal, esophageal, and laryngeal cancer. Oral cavity (53.2%) and larynx (11.6%) were separately the dominant and recessive sites where the UADT‐SCC occurred. Although alcohol and tobacco bestowed increased risks of earlier tumor occurrence only for oral/pharyngeal and oral cancers, respectively, TF‐BQ was consistently observed to confer elevated age‐associated risks for each UADT‐SCC [adjusted hazard ratio (aHR) = 1.6–2.3]. Alcohol and TF‐BQ joint consumers experienced a stepwise increased cumulative risk (CR) of contracting carcinomas of the larynx (46.2%), esophagus (47.5%), pharynx (53.5%), and oral cavity (60.5–71.0%), with >68% of CRs found among drinkers who started chewing before age 20. Alcohol + Betel + Cigarette and Alcohol + Betel users exhibi‐ted earlier diagnosis ages than non‐users: 10 years ahead for oral cancer, 7, 17, and 12 years earlier for pharyngeal, esophageal, and laryngeal cancers. Noticeably, higher cumulative cancer risks regarding earlier tumor occurrence were correspondingly identified for these users aged 43, 49, 43, and 44 upward. Conclusions: Tobacco‐free betel‐quid, in conjunction with alcohol and/or tobacco consumption, impacts early cancer occurrence for specific UADT‐SCC and influences tumor site incidence pattern of these neoplasms.  相似文献   

19.
After their initial presentation of oral squamous cell carcinoma (SCC), patients have a lifelong risk of developing another new SCC of the head and neck. The aim of this study was to establish second primary rates, baseline characteristics (site, clinical or pathological stage, and smoking and alcohol history), timing, presentation, treatment, and outcomes. From the regional unit we analysed records of patients treated with curative intent for their first oral cancer between 2002 and 2007 inclusive. All patients had had at least 10 years of follow up either to death or the end of 2017. A total of 347 patients had been treated with curative intent, and of them, 29 had a second primary at a median (IQR) of 52 (30-79) months after the index operation. The incidence of developing a second primary tumour within two years was 1.7% (95% CI: 0.7% to 3.7%), within five years was 4.9% (95% CI: 2.9% to 7.7%), and within 10 years was 7.8% (95% CI: 5.1% to 11.1%). Early stage of first cancer was the only significant factor (p = 0.001) for development of a second primary within 10 years, reflecting survivorship. Most second primaries (21 patients) were staged as early, and by visual inspection. Most (n = 20) were within the oral cavity, one of which overlapped the oropharynx; eight others were in the oropharynx, and one in the larynx. Most patients (n = 22) were treated by operation with curative intent. Three were treated palliatively. Patients need to be aware of the risk of a second primary and, as most are in the mouth or oropharynx, there is a role for surveillance by primary dental care practitioners.  相似文献   

20.
Tobacco use is considered to increase the risk of tumor induction. The purpose of this case-controlled investigation was to assess the association of tobacco habits and development of squamous cell carcinoma of the lower lip. Sixty-one patients treated for lower lip cancer, aged between 42 and 90 years, were studied. Age- and sex-matched healthy controls showed a similar exposure to tobacco in years and a comparable distribution of tobacco habits. Although the mean exposure factor (duration times exposure) was greater in the tumor group, no intimate correlation between lip cancer and tobacco was demonstrated. However, an increased, although small, occurrence of herpes labialis lesions was found in cancer patients. The hypothesis is presented that smokers experiencing recurrent herpes simplex virus 1 (HSV-1) infections are more liable to tumor initiation, which issue will be subjected to a future study.  相似文献   

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