PROSTHODONTICS - American College of Prosthodontists
PROSTHODONTICS - American College of Prosthodontists
PROSTHODONTICS - American College of Prosthodontists
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Race/EthnicitydataTables1‐9presentdifferencesamongrace/ethnicitygroups.Thepotentialfordeathfromoralcanceramongstblackswas1.7timesthat<strong>of</strong>whites(Arbes,CancerCausesandControl1999;10:513‐523).Theincidence<strong>of</strong>cancers<strong>of</strong>theoralcavity,pharynx,andlarynxwerehigherforAfrican‐<strong>American</strong>sthanwhites.Likewise,the5‐yearsurvivalratesweresignificantlylowerforAfrican‐<strong>American</strong>s(Shavers,CancerandMetastatisReviews2003;22:25‐28).Datawereobtainedfrom21,481malignancies<strong>of</strong>theoralcavityandpharynxdiagnosedbetween1988and1998intheState<strong>of</strong>Florida.Blacksconsistentlyhadsurvivalratesthatwerepoorerthanwhitesandtherewasahigherincidence<strong>of</strong>metastasisamongblacks.Ninepercent<strong>of</strong>tumorsinwhiteshadmetastasizedatthetime<strong>of</strong>diagnosiswhereas19.7%<strong>of</strong>thetumorsinblackshadmetastasized(Tomar,Cancercausesandcontrol2004;15:601‐609).Astudy<strong>of</strong>oralandpharyngealcancerfortheyears1996‐2002indicatedHispanicmenhadincidenceratesapproximately75%higherthannationalratesinNewYorkStateand89%higherthannationalratesinNewYorkCity.Incidenceratesformaleswere16%higherthannon‐HispanicWhitesinNewYorkStateand32%higherthanWhitesinNewYorkCity.NosubstantialdifferenceswererecordedforHispanicwomen.Mortalityratesweresimilartoincidenceratesforbothmenandwomen(Cruz,AmJPubHealth2006;96:2194‐2200).Disparitiesexistbetweenblackandwhitemales,particularlyregardingmortalityfromoralandpharyngealcancer(OPC).Age‐adjustedincidenceratesweremorethan20percenthigherforblackmalesthanwhitemaleswithlittledifferenceinblackandwhitefemales.Ageadjustedmortalityrates(AAMR)were82percenthigherforblackmalesthanwhitemaleswithsimilarratesforblackandwhitefemales(Morse,JAmDentAssoc2006;137:2‐3‐212).African‐<strong>American</strong>shadasignificantlyhigherproportion<strong>of</strong>oralcancer(mainlyinthetongue)thathadspreadtoaregionalnodeordistantsiteatthetime<strong>of</strong>diagnosisthanWhites.From1988to2002,theproportions<strong>of</strong>thecancersthathadspreadwere70%forAfrican‐<strong>American</strong>sand53%forWhites.Additionally,African‐<strong>American</strong>shadasignificantlyhigherproportion<strong>of</strong>tonguecancersthatweregreaterthan4millimetersindiameteratthetime<strong>of</strong>diagnosis.Theauthorsconcludedtherearesignificantracialdifferencesrelativetothestage<strong>of</strong>thecanceratthetimeitwasdiagnosedandthesurvivalrateamongadults.TheauthorsindicatedthelowersurvivalamongBlacksmaybeduetodifferencesintheaccessandutilization<strong>of</strong>healthcareservices(Shiboski,CommunityDentOralEpidemiol2007;35:233‐240).GeneticsdataThefollowingsixgeneswerecommontoallcarcinomacelllines:IgCmuheavychainconstantregion;semaphorin;T‐cellgrowthfactor;cAMP‐dependentproteinkinasebeta‐catalyticsubunit;desmocollin1A/1Bprecursor;andrecA‐likeproteinHsRad51.Allthesegeneswerealsodown‐regulatedin3<strong>of</strong>the6lines<strong>of</strong>oralcancercells.Theauthorsconcludedthatthedatasuggests“oralcancinomaswithdifferentetiologicalbackgroundscanbedistinguishedbytheirdifferentglobalgeneexpressionpatterns”(Ruutu,OncolRep2005;14:1511‐1517). 82010 CDEL Re-recognition <strong>of</strong> the Specialty Report 192 <strong>of</strong> 279
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