Precursor lesions of the cervix persist longer and progress more quickly in women with oncogenic HPV infections than in women with non-oncogenic infections or without HPV. Testing cervical lesions for oncogenic HPVs may help identify those that are likely to progress rapidly.
The authors investigated the joint effects of tobacco and alcohol consumption on the risk of squamous cell carcinomas of the upper aero-digestive tract (UADT) using data from a hospital-based case-control study conducted in southern Brazil, 1986-1989. A total of 784 cases of cancers of the mouth, pharynx, and larynx and 1,578 non-cancer controls matched on age, sex, hospital catchment area, and period of admission were interviewed about their smoking and drinking habits and other characteristics. Using logistic regression, evidence was found for interaction between the cumulative exposures for smoking and alcohol on UADT cancer risk. The joint effects for pharyngeal cancers exceeded the levels expected under a multiplicative model for moderate smokers (p = 0.007). There was little statistical evidence, however, for interaction on cancers of the mouth (p = 0.28) or larynx (p = 0.95). Among never smokers, heavy drinkers had 9.2 times (95% confidence interval 1.7, 48.5) greater risk of cancers of mouth, pharynx, and supraglottis than never drinkers, with a dose-response trend (p = 0.013) with cumulative consumption. The authors conclude that the interaction occurring in the pharynx between smoking and alcohol on UADT cancers is not uniform, with varying effects depending on the level of smoking exposure. Alcohol may act as both a promoter for tobacco and as an independent risk factor.
We examined the relationship between dental health variables and risk of upper aerodigestive tract (UADT) cancers in a case-control study in Southern Brazil. The study population included 717 cases of cancers of the mouth, pharynx, and larynx and 1434 controls matched on age, gender, period of admission and study site. The association with dental factors was investigated by conditional logistic regression using extensive adjustment for a priori and empirical confounders, including tobacco and alcohol consumption, diet and sociodemographic variables. Lifetime use of dentures was not associated with risk of any UADT cancer, but history of oral sores secondary to ill-fitting dentures was associated with cancers of the mouth (odds ratio [OR] = 2.3, 95% confidence interval [CI] 1.2-4.6) and of the pharynx (OR = 2.7, 95% CI 1.1-6.2) among those using dentures. The association for mouth cancers was restricted primarily to an increased risk of tongue neoplasms (OR = 9.1, 95% CI 1.9-43.4). Less than daily tooth brushing frequency was also associated with risk of cancer of the tongue (OR = 2.1, 95% CI 1.0-4.3) and of other parts of the mouth (OR = 2.4, 95% CI 1.0-5.4). Having broken teeth was not significantly associated with risk of UADT cancer of any site. We conclude that poor oral hygiene due to infrequent tooth brushing and sores caused by dentures are risk factors for cancer of the mouth and that these associations are unlikely to be due to insufficient control of confounding.
Most laboratory models of head and neck squamous cell cancer (HNSCC) rely on established immortalized cell lines, which carry inherent bias due to selection and clonality. We established a robust panel of HNSCC tumor cultures using a "conditional reprogramming" (CR) method, which utilizes a rho kinase inhibitor (Y-27632) and co-culture with irradiated fibroblast (J2 strain) feeder cells to support indefinite tumor cell survival. Sixteen CR cultures were successfully generated from 19 consecutively enrolled ethnically and racially diverse patients with HNSCC at a tertiary care center in the Bronx, NY. Of the 16 CR cultures, 9/16 were derived from the oral cavity, 4/16 were derived from the oropharynx, and 3/16 were from laryngeal carcinomas. Short tandem repeat (STR) profiling was used to validate culture against patient tumor tissue DNA. All CR cultures expressed ΔNp63 and cytokeratin 5/6, which are markers of squamous identity. Human papillomavirus (HPV) testing was assessed utilizing clinical p16 staining on primary tumors, reverse transcription polymerase chain reaction (RT-PCR) of HPV16/18-specific viral
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