Oral Cancer Risk Factors
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1 Oral Cancer Risk Factors Linda M Kaste, DDS, MS, PhD Diplomate, American Board of Dental Public Health Professor, University of Illinois at Chicago College of Dentistry
2 Objective and Content Objective: The session attendees will be able to: discuss updates about risk factors including subsite specific associations in the United States Meta analyses: Traditional risk factors for oral cavity (OCC) and oropharyngeal (OPC) cancers HPV INHANCE pooled data
3 Methods Targeted literature review Published January 1995 March 2016 English If at least one clinical trial was from the US MeSH terms Behavior, risk Risk reduction behavior Risk factors Risk assessment
4 Meta analyses of Oral Cavity Cancer (OCC) Risk Factors: identified with statistical significance Tobacco (smoking) No meta analyses Often included as an adjustment factor Most frequently assessed, 2 each Alcohol Diet HPV Smokeless tobacco
5 Statistically Significant Risk Factors for Oral Cavity Cancers (OCC): Meta analyses OR 1/1995 3/2016
6 Meta analyses of Oropharyngeal Cancer (OPC) Risk Factors: identified Most frequently assessed with 2 was Alcohol Only one factor preventive = Coffee Particularly high risks [note scale on next slide compared to 6 on previous slide] Heavy alcohol drinking HPV Smoking tobacco Smokeless tobacco
7 Statistically Significant Risk Factors for Oropharyngeal Cancers (OPC): OR Meta analyses 1/1995 3/2016
8 INHANCE INternational Head And Neck Cancer Epidemiology Consortium Additional Insight on Risk Factors
9 INHANCE International Head and Neck Cancer Epidemiology (INHANCE) Consortium Established in 2004 Collectively: 26,000+ cases 34,000+ controls Conducted in various regions of the world
10 INHANCE Pooled Data for Subsites of Interest: Reports 1/1995 3/ papers 8: Diet 5: Smoking Tobacco/Smoking Tobacco & Alcohol 4: Height/BMI 1: Age, Alcohol, Coffee, Diabetes, Family History, Marijuana, Mouthwash, Recreational Activity, Sex Behaviors, and SES OCC = Oral Cavity Cancer OPC = Oropharyngeal Cancer P = Cancer of the Pharynx H&N = Cancer of the Head and Neck OCPC = Oral Cavity and Pharynx Cancer BOT = Cancer at the Base of Tongue
11 INHANCE Age and Alcohol OR >15 standard drinks/week
12 OR INHANCE Diet (Preventive)
13 OR INHANCE Height & BMI
14 OR INHANCE Tobacco
15 INHANCE Exclusive/Joint Tobacco Smoking OR
16 OR INHANCE Other
17 Summary of Risk Factors Many factors associated with > risk of OC HPV and sexual behaviors of great concern Tobacco exposure remains a major factor Albeit smoking not a focus of recent OCC meta analysis Few factors associated with < risk of OC Importance of dietary factors and wellness Site matters Genetics and genetic interactions with etiological agents will bring further perspectives for improving early detection and prevention
18 Reference LeHew CW, Weatherspoon DJ, Peterson CE, Goben A, Reitmajer K, Sroussi H, Kaste LM. The Health System and Policy Implications of Changing Epidemiology for Oral Cavity and Oropharyngeal Cancers in the United States from 1995 to Epidemiologic Reviews 2017: In Press.
19 Prevalence of HPV in Adults Aged United States, (NHANES) Any Oral HPV (%) High risk Oral HPV (%) McQuillan G, et al. Prevalence of HPV in Adults Aged 18 69: United States, NCHS data brief, no Hyattsville, MD: National Center for Health Statistics
20 Prevalence of HPV in Adults Aged United States, (NHANES) Any Genital HPV (%) High risk Genital HPV (%) McQuillan G, et al. Prevalence of HPV in Adults Aged 18 69: United States, NCHS data brief, no Hyattsville, MD: National Center for Health Statistics
21 Reference McQuillan G, Kruszon Morgan D, Markowitz LE, Unger ER, Paulose Ram R. Prevalence of HPV in adults aged 18 69: United States, NCHS data brief, no Hyattsville, MD: National Center for Health Statistics Accessed April 6, 2017.
22 Thank you!
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