Sites of origin of oral cavity cancer in nonsmokers vs smokers: Possible Evidence of Dental Trauma Carcinogenesis and Its Importance Compared with Human Papillomavirus

Perry, Brendan J, Zammit, Andrew P, Lewandowski, Andrew W, Bashford, Julia J, Dragovic, Adrian S, Perry, Emily J, Hayatbakhsh, Reza and Perry, Christopher F. L (2015) Sites of origin of oral cavity cancer in nonsmokers vs smokers: Possible Evidence of Dental Trauma Carcinogenesis and Its Importance Compared with Human Papillomavirus. JAMA Otolaryngology - Head and Neck Surgery, 141 1: 5-11. doi:10.1001/jamaoto.2014.2620

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Author Perry, Brendan J
Zammit, Andrew P
Lewandowski, Andrew W
Bashford, Julia J
Dragovic, Adrian S
Perry, Emily J
Hayatbakhsh, Reza
Perry, Christopher F. L
Title Sites of origin of oral cavity cancer in nonsmokers vs smokers: Possible Evidence of Dental Trauma Carcinogenesis and Its Importance Compared with Human Papillomavirus
Journal name JAMA Otolaryngology - Head and Neck Surgery   Check publisher's open access policy
ISSN 2168-6181
2168-619X
Publication date 2015-01
Year available 2015
Sub-type Article (original research)
DOI 10.1001/jamaoto.2014.2620
Open Access Status File (Publisher version)
Volume 141
Issue 1
Start page 5
End page 11
Total pages 7
Place of publication Chicago, United States
Publisher American Medical Association
Collection year 2016
Language eng
Formatted abstract
Importance The relatively high and possibly rising incidence of mouth squamous cell carcinoma in nonsmokers, especially women, without obvious cause has been noted by previous authors. Is chronic dental trauma and irritation a carcinogen, and what is its importance compared with human papillomavirus (HPV) oropharyngeal cancer in nonsmokers?

Objective To determine whether oral cavity cancers occurred more commonly at sites of dental trauma and how the position of these cancers varied between nonsmokers lacking major identified carcinogens and smokers. If these cancers occurred more frequently at sites of chronic trauma, especially in nonsmokers, it would suggest chronic dental trauma as a possible carcinogen.

Design, Setting, and Participants A retrospective analysis of 881 patients with oral cavity or oropharyngeal cancers seen through a tertiary referral hospital between 2001 and 2011 was performed.

Main Outcomes and Measures Patient medical records were analyzed to determine the location of the tumor within the oral cavity and oropharynx and how it relates to patient demographics, smoking and alcohol histories, and comorbidities. Dental histories were also sought, including use of dentures.

Results
Nonsmokers comprised 87 of 390 patients with mouth cancer (22%) and 48 of 334 patients with oropharyngeal cancer (14%). Female nonsmoking patients included 53 with oral cancer (61%) but only 12 with oropharyngeal squamous cell carcinoma (25%). Oral cancers occurred on the lateral tongue, a potential site of chronic dental trauma, in 57 nonsmokers (66%) compared with 107 smokers/ex-smokers (33%) (P < .001). Gingival and floor of mouth lesions occurred in older patients, possibly from chronic denture rubbing. Twenty-six patients had dental abnormalities recorded in close proximity to where their tumor developed.

Conclusions and Relevance Oral cavity cancers occur predominantly at sites of potential dental and denture trauma, especially in nonsmokers without other risk factors. Recognizing teeth irritation as a potential carcinogen would have an impact on prevention and treatment strategies.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Official 2016 Collection
School of Public Health Publications
School of Medicine Publications
 
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