Molecular basis of oral squamous cell carcinoma in young patients: Is it any different from older patients?

Abstract

Oral squamous cell carcinoma (OSCC) is the commonest subtype of oral cancer, mainly affecting older patients. It used to be a rare disease among individuals younger than 40 years, but recently increased incidences in this age group are being reported worldwide. The pathogenesis of OSCC affecting young patients remains controversial, and the well-known etiological factors for oral cancer, tobacco, and alcohol use are believed to play a minor role in the carcinogenesis of the neoplasm, suggesting that the etiology and the molecular basis of OSCC may differ between younger and older patients. Although several molecular markers and chromosomal abnormalities have been demonstrated to differ between both groups, most of the studies have failed to find significant differences. Moreover, divergent results have also been obtained regarding the presence of high-risk human papillomavirus infection in OSCC of young patients. Given these contradictory results and the limited methodological approaches of the majority of the studies, the exact difference between both age groups remains to be fully established. In this review, we evaluate the available data to establish the current evidence that might support the hypothesis that the molecular basis of OSCC in young patients (especially those under 40 years) differ from the older patients.

Head and neck squamous cell carcinoma in young patients: a 26-year clinicopathologic retrospective study in a Brazilian specialized center

“…The HNSCC in elderly women is also believed to be a distinct disease by some researchers, and is recently being target for deeper investigation, including in our center. Epidemiological trends for HNSCC in young people might be determined by a distinct etiologic background (5)(6)(7). Although most patients in all groups of the current study were smokers, more patients from the young group were never exposed to this habit ( Table 2), corroborating with other studies from Brazil (9), The Netherlands (14), and China (22).…”

“…These differences might be due to different behavioral profiles regarding the risk factors for the disease (tobacco and alcohol) in different cultures (4). HNSCC has a low incidence in people younger than 45-years-old (5,6). This is possibly explained by the fact that young patients are not exposed to tobacco and alcohol in the same intensity and duration as older patients (5,6).…”

“…HNSCC has a low incidence in people younger than 45-years-old (5,6). This is possibly explained by the fact that young patients are not exposed to tobacco and alcohol in the same intensity and duration as older patients (5,6). Based on the etiology and disease behavior, HN-SCC in young people is considered a distinct pathologic entity by some researchers (6,7).…”

“…This is possibly explained by the fact that young patients are not exposed to tobacco and alcohol in the same intensity and duration as older patients (5,6). Based on the etiology and disease behavior, HN-SCC in young people is considered a distinct pathologic entity by some researchers (6,7). Thus, other etiologic factors for this disease have been investigated in the young population with HNSCC (3).…”

Molecular profile of tongue cancer in an 18‐year‐old female patient with no recognizable risk factor

“…The etiology of TSCC in these nonsmoking young individuals not related to human papillomavirus is unclear . A recent review of the available molecular data on TSCC in both young and old patients showed no significance differences between the two groups despite the presence of several molecular markers and chromosomal abnormalities . It has however been suggested that an increase of exposure to known risk factors like environmental smoke could be a driving factor of TSCC in young adults.…”