PROSTHODONTICS - American College of Prosthodontists
PROSTHODONTICS - American College of Prosthodontists
PROSTHODONTICS - American College of Prosthodontists
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Inaprospectivestudy(NIH‐AARPDietandHealthStudy)<strong>of</strong>cancerintheoralcavity,theoropharynxandhypopharynx,andthelarynx,drinkingmorethan3alcoholicbeveragesperdaywasassociatedwithincreasedcancerriskinbothmenandwomen.However,consumption<strong>of</strong>uptoonedrinkperdaymaybeassociatedwithreducedriskrelativetonondrinking.Thehazardratios“fortheassociationbetweenalcoholintakeandheadandneckcancerriskweresignificantlyhigherforwomenthanmen”(Freedman,BrJCancer2007;96:1469‐14740.SundataThelipisasiteaffectedbyexposuretosunlight,<strong>of</strong>tenasaresult<strong>of</strong>occupationalorrecreationalexposure.Theage‐relatedincidence<strong>of</strong>lipcancer(number<strong>of</strong>newcasesdiagnosedper100,000personaatrisk)2.1inwhitemalesand0.4inwhitefemales.Thecorrespondingincidencenumberinblackswas0.1formalesand0.2forfemales.Theincidencerateintheoralcavity(tongue,floor<strong>of</strong>themouth,gingiva,andother)was5.3andthepharyngealincidencewas2.8(Table4).Thecombinedmaleandfemalemortalityratesforbothwhitesandblackswas0.0(Table5)(Morse,JAmDentAssoc2006;137:203‐212).Humanpapillomavirus(HPV)dataAcase‐controlledstudy<strong>of</strong>284subjectswhowererecentlydiagnosedwithoralsquamouscellcarcinomaconcludedthat“HPVtype16infectionmaycontributetothedevelopment<strong>of</strong>asmallproportion<strong>of</strong>oralSCCsinthispopulation,mostlikelyincombinationwithcigarettesmoking”(Schwartz,JNatlCancerInst1998;90:1626‐1636).Inagroup<strong>of</strong>93recentlydiagnosespatientswithoralorpharyngealcancer,HPVwasfoundtoplayaroleinthedevelopment<strong>of</strong>oralcancer(Smith,Laryngoscope1998;108:1098‐1103).“HPVappearstoplayanetiologicroleinmanycancers<strong>of</strong>theoropharynxandpossiblyasmallsubgroup<strong>of</strong>cancers<strong>of</strong>theoralcavity.ThemostcommonHPVtypeingenitalcancers(HPV16)wasalsothemostcommoninthesetumor”(Herrero,JNatlCancerInst2003;95:1772‐1783).Theprevalence<strong>of</strong>oncogenicmucosalHPVishigherinyounger‐ageoralcavity/oropharynxcancercaseswhosesexualpracticesaretypicallyassociatedwithsexualtransmission<strong>of</strong>thevirus”(Smith,IntJCancer2004;108;766‐772).“Thelatestmeta‐analyses<strong>of</strong>theepistudiesaswellasthemulti‐centercase‐controlledstudieshaveconfirmedHPVasanindependentriskfactorfororalcancer,witharange<strong>of</strong>oddsratiosbetween3.7and5.4.”Uptotheyear2002,22%<strong>of</strong>4,768oralcarcinomaswerereportedtocontainthehumanpapillomavirus.Thehighestprevalence<strong>of</strong>HPVwasfoundintonsillarcarcinomas(Syriänen,JClinVirol2005;32suppl1;S59‐66).“OralHPVinfectionisstronglyassociatedwithoropharyngealcanceramongsubjectswithorwithouttheestablishedriskfactors<strong>of</strong>tobaccoandalcoholuse.”Currentsmokingwasfoundtoincreasetheodds<strong>of</strong>persistentoralHPVinfections.Thenaturalhistory<strong>of</strong>oralHPVinfectionsmaybedistinctfromcervicalHPVinfections(D’Souza,IntJCancer2007;121:143‐150). 72010 CDEL Re-recognition <strong>of</strong> the Specialty Report 191 <strong>of</strong> 279
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