Racial Differences in Risk of Oral and Pharyngeal Cancer: Alcohol, Tobacco, and Other Determinants

Day, Gina L.; Blot, William J.; Austin, Donald F.; Bernstein, Leslie; Greenberg, Raymond S.; Preston‐Martin, Susan; Schoenberg, Janet B.; Winn, Deborah M.; McLaughlin, Joseph K.; Fraumeni, Joseph F.

doi:10.1093/jnci/85.6.465

Cited by 184 publications

(161 citation statements)

References 19 publications

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“…Our AA patients were more likely to be smokers and heavy drinkers as compared with our CA cohort. This has been substantiated in previous studies, including that of Day et al, 13 who evaluated data from a large, population-based case-control study of oral cancer risk factors conducted in 4 areas of the United States. They found that AA patients were more likely to smoke and abuse alcohol compared with the CA patients in their population of SCCHN.…”

Section: Discussionsupporting

confidence: 52%

“…There have been numerous hypotheses published as to the etiology of this racial disparity. [10][11][12][13][14][15] Specifically, factors such as socioeconomic status, unequal cancer directed therapy, and advanced stage of presentation have been sited as an explanation for the poor outcomes in AA patients. [14][15] In 2006, Gourin and Podolsky published data from a nonrandomized retrospective cohort analysis to determine whether racial disparities exist between black and white patients with SCCHN treated at a single large institution in the South.…”

Section: Discussionmentioning

confidence: 99%

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Race impacts outcome in stage III/IV squamous cell carcinomas of the head and neck after concurrent chemoradiation therapy

Settle

Taylor

Wolf

et al. 2009

Cancer

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BACKGROUND:The purpose of this study was to determine the impact of race on outcome in patients with stage III/IV squamous cell carcinoma of the head and neck (SCCHN) who have completed concurrent chemoradiotherapy.METHODS:The authors performed a retrospective analysis of 202 patients with stage III/IV SCCHN who were treated at the University of Maryland. Patients received daily radiation to a total dose of 70.2 Gray (Gy) (1.8 Gy/day), concurrently with weekly carboplatin (area under the curve [AUC] = 2) and paclitaxel (45 mg/m2) chemotherapy.RESULTS:There were 108 Caucasian (CA) and 94 African American (AA) patients. The median age was 56 years, and 81% were stage IV. The median follow‐up was 33 months. The median overall survival (OS) and disease‐free survival (DFS) were 33 months and 19 months, respectively. When analyzed by race, the median DFS was 33 months (CA) versus 12 months (AA) (P = .028). The median OS was 44 months (CA) versus 24 months (AA) (P = .071). The 3‐year DFS for stage IV AA versus stage IV CA was 29% versus 50% (P = .031). The 3‐year DFS for N2 disease in AA versus CA was 32% versus 51% (P = .046). The 3‐year DFS for AA versus CA with oropharyngeal tumors was 30% versus 60% (P = .006).CONCLUSIONS:This analysis documents the inferior outcome for AA patients. They had inferior DFS and a trend toward worse OS. When stratified by several prognostic variables, the mediocre DFS in the AA patients remains. These data suggest that further investigation into the genetic characteristics of SCCHN in AA patients is warranted. Cancer 2009. © 2009 American Cancer Society.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Race impacts outcome in stage III/IV squamous cell carcinomas of the head and neck after concurrent chemoradiation therapy

Settle

Taylor

Wolf

et al. 2009

Cancer

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“…It is now well established that genetic factors play a significant role in determining risk for both cancer and coronary heart disease (198,199) and behavioral factors such as cigarette smoking and heavy consumption of alcohol also influence susceptibility to these diseases (199)(200)(201). Nevertheless, when these factors are taken into consideration, dietary caloric consumption may be one of the most important risk factors for a spectrum of human degenerative diseases (4,202), and human epidemiology studies have established that increased body weight-or body mass index (BMI)-is positively correlated to a number of morbidity/mortality indices.…”

Section: Influence Of Caloric Intake On Human Morbidity and Mortalitymentioning

confidence: 99%

Caloric restriction as a mechanism mediating resistance to environmental disease.

Frame

Hart

Leakey

1998

Environ Health Perspect

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It has been observed that susceptibility to many degenerative diseases increases concurrently with industrialization and rising living standards. Although epidemiologic studies suggest that specific environmental and dietary factors may be important, caloric intake alone (as reflected in body size) may account for much of the differential risk observed among diverse human populations. It has been suggested from animal studies that caloric intake may be the primary effector for many hormonal, metabolic, physiologic, and behavioral responses that coordinate reproductive strategy to apparent availability of food. When caloric intake is excessive, particularly at critical developmental stages, physiologic priorities are set for body growth and fecundity rather than for endurance and longevity. The converse occurs during periods of famine, thus increasing the probability that sufficient individuals survive to restore the population when conditions improve. Calorically restricted rodents have significantly longer reproductive and total life spans than their ad libitum-fed controls and exhibit a spectrum of biochemical and physiologic alterations that characterize their adaptation to reduced caloric intake. These include reduced stature, hypercorticism in the absence of elevated adrenocorticotropic hormone levels, increased metabolic efficiency, decreased mitogenic response coupled with increased rates of apoptosis, reduced inflammatory response, induction of stress proteins and DNA repair enzymes, altered drug-metabolizing enzyme expression, and modified cell-mediated immune function. The overall profile of these changes is one of improved defense against environmental stress. This has been suggested as the mechanistic basis for the protective effects of low body weight on radiationand chemically induced cancers in experimental animals. It may also explain the significantly higher thresholds of acute toxicity observed when calorically restricted rodents are exposed to certain test compounds.

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“…Estes tumores são representados em 90 a 95% dos casos pelo carcinoma epidermóide [1][2][3][4][5][6][7] . Acometem com mais freqüência o sexo masculino na 5ª e 6ª décadas de vida 8 , sendo em 80% atribuído a fatores ambientais, dietéticos, ocupacionais, infecção viral, fator imunológico e alterações genéticas 9,10 . Porém, o fator de risco dominante e comum a quase todos os portadores de câncer de orofaringe continua sendo o consumo de bebida alcoólica em associação ao tabaco 1,7,[11][12][13][14][15][16][17] .…”

Section: Introductionunclassified

Paradigma da disseminação local do carcinoma epidermóide da base de língua

Filho

Sobrinho

Rapoport

et al. 2004

Rev. Bras. Otorrinolaringol.

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OBJETIVO: Analisar o padrão de disseminação local através da delimitação clínica da extensão da lesão primária assim como os subsítios invadidos. FORMA DE ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: Foram analisados os prontuários de 290 pacientes com carcinoma epidermóide de base de língua no Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia do Hospital Heliópolis, Hosphel, São Paulo - Brasil, de 1977 a 2000, sendo estadiados pelo TNM da UICC, e os resultados analisados pelo teste do Quiquadrado para tabelas Z x N (Cochran) para estudo da associação dos sítios e dimensão da neoplasia em relação à invasão da linha média. RESULTADOS: Com predomínio dos homens (8:1) e da 6ª década de vida (41,0%), 83,8% eram etilistas e tabagistas e em 4,7% os hábitos estavam ausentes. Quanto aos sintomas, odinofagia (37,6%), linfonodo (21,7%) e a média de tempo entre o 1º sintoma e o diagnóstico de 6 meses (62,0%). Quanto ao estadiamento, tivemos T1-T2 (18,3%), T3 (32,4%), T4(50,7%). Quanto à disseminação local, em direção à valécula (25,3%), epiglote (18,7%), glote (2,7%), anteriormente para o v lingual em (22,4%) e póstero lateralmente para a prega faringloepiglótica (6,6%) e seio piriforme (2,2%). Quanto a ultrapassagem da linha média, isso ocorreu em 66,2% dos casos, sendo 42,2% (T2), 54,2% (T3) e 82,9% (T4). CONCLUSÃO: o carcinoma epidermóide no estádio T4 ultrapassa a linha média da base da língua em 82,9%.

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Racial Differences in Risk of Oral and Pharyngeal Cancer: Alcohol, Tobacco, and Other Determinants

Abstract: These findings suggest that the key to prevention of oral and pharyngeal cancers among both Blacks and Whites is reduced intake of alcoholic beverages and, because of strong interactive effects, the cessation of smoking.

Cited by 184 publications

References 19 publications

Race impacts outcome in stage III/IV squamous cell carcinomas of the head and neck after concurrent chemoradiation therapy

Race impacts outcome in stage III/IV squamous cell carcinomas of the head and neck after concurrent chemoradiation therapy

Caloric restriction as a mechanism mediating resistance to environmental disease.

Paradigma da disseminação local do carcinoma epidermóide da base de língua

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