1
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Giddey AD, Hagyousif YA, Soares NC, Al-Hroub HM, Aghila Rani KG, Zaher DM, Omar H, Al Kawas S, Semreen MH, Al-Rawi N. Comparative proteomic analysis of saliva from chewing tobacco users and oral cancer patients reveals shared biomarkers: A case control observational study. J Dent 2024; 149:105268. [PMID: 39089670 DOI: 10.1016/j.jdent.2024.105268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE The aim of this study was to compare the salivary proteomic profile of smokeless tobacco users with that of non-users and oral cancer patients using Liquid Chromatography-Mass Spectrometry/ Mass Spectrometry (LC-MS/MS). METHODS Saliva samples from 65 participants were collected in three groups: control (25 participants), smokeless tobacco users (25 participants), and oral cancer (15 participants). RESULTS The analysis revealed 343 protein groups with significantly altered abundance in the saliva samples (P < 0.05). Among these, 43 out of 51 dysregulated proteins in the smokeless tobacco group were also dysregulated in the oral cancer group. Notably, Apolipoprotein A1 (ApoA1) and Pon1 were found to be significantly increased in both smokeless tobacco users and oral cancer patients (p < 0.05). Furthermore, six out of the 20 most significantly altered proteins were mitochondrial proteins, and all of these were decreased relative to controls in both smokeless tobacco users and cancer samples. CONCLUSION The proteomic profile of users of chewing (smokeless) tobacco (SLT) shows substantial overlap in the altered pathways and dysregulated proteins with those altered in oral cancer samples, suggesting that SLT use induces a shift toward an oncogenic state. Specifically indicated pathways included blood microparticles, platelet α-granules and protease inhibitors as well as indicators of oxidative stress and exogenous compound processing. What differentiates oral cancer samples from SLT users is enrichment of alterations related to cytoskeletal organisation and tissue remodelling. CLINICAL SIGNIFICANCE The findings emphasize the importance of salivary proteomic profiles because changes in certain proteins may be indicators for early oral cancer identification and risk assessment in smokeless tobacco users.
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Affiliation(s)
- Alexander D Giddey
- Canter for Applied and Translational Genomics, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates; Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Yousra A Hagyousif
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; College of Pharmacy, Department of Medicinal Chemistry, University of Sharjah, United Arab Emirates
| | - Nelson C Soares
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; College of Pharmacy, Department of Medicinal Chemistry, University of Sharjah, United Arab Emirates; Laboratory of Proteomics, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal; Centre for toxicogenomic and Human Health (ToxOmics), NOVA School/ Faculdade de Lisboa, Lisbon, Portugal
| | - Hamza M Al-Hroub
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - K G Aghila Rani
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Dana M Zaher
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Hany Omar
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; College of Pharmacy, Department of Pharmacy practice and Pharmacotherapeutics, University of Sharjah, United Arab Emirates
| | - Sausan Al Kawas
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; College of Dental Medicine, Department of Oral & Craniofacial Health Sciences, University of Sharjah, United Arab Emirates
| | - Mohammad H Semreen
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; College of Pharmacy, Department of Medicinal Chemistry, University of Sharjah, United Arab Emirates.
| | - Natheer Al-Rawi
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; College of Dental Medicine, Department of Oral & Craniofacial Health Sciences, University of Sharjah, United Arab Emirates.
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2
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Chan EL, Rovira A. Head-and-neck Cancer in the Emergency Department: A Contemporary Review of Common Presentations and Management. J Emerg Trauma Shock 2024; 17:33-39. [PMID: 38681881 PMCID: PMC11045002 DOI: 10.4103/jets.jets_40_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/21/2023] [Accepted: 12/04/2023] [Indexed: 05/01/2024] Open
Abstract
Head-and-neck cancer (HNC) can present with life.threatening symptoms in the emergency department. Patients can sometimes be misdiagnosed with pulmonary disease due to similar signs and symptoms, ultimately leading to delayed diagnosis and potentially devastating consequences. Reasons for this include lack of awareness of patient risk factors and knowledge of the myriad of presenting complaints in the disease process among physicians working in primary care and in the emergency department. This article explores the contemporary risk factors and common presenting symptoms and discusses initial management for a patient with potential head-and-neck malignancy. Emergency presentations of HNC are wide ranging and can overlap with common respiratory pathologies. Clinician awareness of this can assist the team in deciding what appropriate examination and investigations are required to reduce the risk of delaying diagnosis and further treatment.
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Affiliation(s)
- Ee Lyn Chan
- Department of Anesthesia, Maidstone and Tunbridge Wells Hospital, Royal Tunbridge Wells, Maidstone, UK
| | - Aleix Rovira
- Department of Head and Neck Surgery, Guy's and St. Thomas' Hospital, Great Maze Pond, London, UK
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3
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Paul B, Jean Simon D, Kondo Tokpovi VC, Kiragu A, Balthazard-Accou K, Emmanuel E. Tobacco use in Haiti: findings from demographic and health survey. BMC Public Health 2023; 23:2504. [PMID: 38097954 PMCID: PMC10720190 DOI: 10.1186/s12889-023-17409-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Although tobacco has harmful effects on the physical and mental health of individuals, its use remains significant, according to the World Health Organization. To understand this phenomenon, studies have been carried out in many countries around the world, while in Haiti where more than 5,000 people die each year due to tobacco use, little is known about the use of this substance. The aim of this study was to examine the prevalence and the factors associated with tobacco use in Haiti. METHODS We used data from the 2016/17 Haitian Demographic Health Survey. Both descriptive and multivariate analyses were conducted using STATA 16.0 software to assess the prevalence and identify factors associated with tobacco use. Results were reported as adjusted odds ratios with 95% confidence intervals. Statistical significance was declared at p < 0.05. RESULTS The prevalence of tobacco use was estimated at 9.8% (95% CI: 9.2-10.4) among men and 1.7% (95% CI: 1.5-1.9) among women. Although the prevalence of tobacco use was low among young people, it increased with age. Respondents aged 35 and above, with no formal education, non-Christians, divorced/separated/widowed, from poorest households, rural areas, "Aire Métropolitaine de Port-au-Prince" region, with high media exposure had a higher likelihood of tobacco use. CONCLUSION The low prevalence of tobacco use among Haitian women and youth represents a public policy opportunity to prevent these vulnerable groups from starting smoking. Adult male smokers should also be targeted by appropriate policy to reduce the different health burdens associated with tobacco, both for the smokers and other people they may expose to passive smoking. Government and health sector stakeholders, along with community leaders, should create and enforce awareness strategies and rules to control advertisements that encourage irresponsible and health-risky consumption behaviors.
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Affiliation(s)
- Bénédique Paul
- Department of Agro-socio-economics, Chibas, Université Quisqueya, Port-au-Prince, Haiti.
- Groupe d'Etude sur les Sciences de la Durabilité, Université Quisqueya, Port-au-Prince, Haiti.
| | - David Jean Simon
- Bureau d'Etudes et de Recherche en Statistiques Appliquées, Suivi et Evaluation (BERSA-SE), Port-au-Prince, Haiti
| | | | - Ann Kiragu
- Department of Law and Political and Social Sciences, University of Sorbonne Paris Nord, Paris, France
| | - Ketty Balthazard-Accou
- Groupe d'Etude sur les Sciences de la Durabilité, Université Quisqueya, Port-au-Prince, Haiti
- Espace universitaire One Health, Université Quisqueya, Port-au-Prince, Haiti
| | - Evens Emmanuel
- Espace universitaire One Health, Université Quisqueya, Port-au-Prince, Haiti
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4
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Nasir SM, Sultana T, Hashmi S, Ahmed M. Patterns and predictors of periodontal disease and tooth loss among users of smokeless tobacco. BMC Oral Health 2023; 23:428. [PMID: 37370042 DOI: 10.1186/s12903-023-03087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Smokeless tobacco (SLT) products of several different types are widely used in several South Asian countries including Pakistan. These products are consumed in different forms and with different names. The study aims to determine adverse effects of the SLT consumption on periodontal tissues. METHODS This cross sectional study was conducted in Karachi, Pakistan. It recruited 377 users of (SLT) with 231 males (61.3%) and 146 females (38.7%) of age 15 to 45 years. After obtaining informed consent, quantitative data were collected via a questionnaire followed by intra oral clinical examination to determine presence of periodontal diseases using community periodontal index (CPI). To determine the association between periodontal diseases and smokeless tobacco consumption habits, Chi Square test was conducted. RESULTS Gingival recession (Class II-IV) (65.8%) was the most prevalent periodontal disease among SLT users. CPI score was high (CPI score 3 and 4) in 31.3% participants, whereas tooth loss was found in 21%. Among types of SLT products, gutka (28.6%) and betel quid (23.3%) were most commonly used. Using SLT for five or more years was found to be associated with a high CPI score, gingival recession (Class II-IV), moderate to severe tooth mobility, and presence of tooth loss. CONCLUSIONS The study found statistically significant association between duration in years of using SLT and periodontal disease including gingival recession, tooth mobility and tooth loss. However, no significant results were found between retention during single use and frequency of SLT use per day. However, the link of these factors with the periodontal disease cannot be eliminated.
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Affiliation(s)
- Syed Muazzam Nasir
- Department of Biosciences, Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
| | - Tajwer Sultana
- Department of Biosciences, Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
| | - Shahkamal Hashmi
- School of Public Health, Dow University of Health Sciences, Ojha Campus, Gulzar-e-Hijri Road, Scheme 33, Suparco Road, Karachi, Pakistan
| | - Mansoor Ahmed
- School of Public Health, Dow University of Health Sciences, Ojha Campus, Gulzar-e-Hijri Road, Scheme 33, Suparco Road, Karachi, Pakistan.
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5
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Guan S, Bush L, Ji H. An in Vitro Study of Constituents Released from Smokeless Tobacco Products into Human Saliva. J Anal Toxicol 2022; 46:625-632. [PMID: 34155520 DOI: 10.1093/jat/bkab076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/11/2021] [Accepted: 06/21/2021] [Indexed: 11/14/2022] Open
Abstract
Smokeless tobacco (ST) products are used worldwide, and consumption is increasing in the USA. Although ST products are considered to occupy a different position on the tobacco product continuum of risk compared to combusted tobacco products, they can still lead to health problems, including cancer, dental problems and changes in heart rate and blood pressure. Therefore, the determination of harmful and potentially harmful constituents released from ST products into human saliva is important. Four certified reference ST products were tested in this study: loose leaf chewing tobacco (3S1), Swedish-style snus (1S4), snus (1S5) and moist snuff (3S3). These certified reference ST products are manufactured for research purposes, not for human consumption. The reference ST products were used in this study because they have been well characterized and are intended and designed to represent commercial ST products. The reference ST products were incubated in human saliva at 37°C with a range of incubation times for the evaluation of constituents released from these products into human saliva. In this study, alkaloids (nicotine and cotinine), tobacco-specific N-nitrosamines (TSNAs) (N'-nitrosornicotine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone) and benzo[α]pyrene (B[α]P) in the reference ST products and saliva samples were determined by gas chromatography--mass spectrometry (GC--MS), gas chromatography--flame ionization detection (GC--FID), or ultra-performance liquid chromatography--tandem mass spectrometry (UPLC--MS-MS). Our results indicate that the amounts of each constituent released from the reference ST products were altered by the tobacco cut size and product format (pouched or unpouched). The constituents (TSNAs and alkaloids) in moist snuff and loose leaf chewing tobacco were released faster compared to those in Swedish-style snus and snus. B[α]P was only detected in reference moist snuff samples, and only 3.4% of the total B[α]P was released into human saliva after incubation for 60 min, whereas higher percentages of total TSNAs and alkaloids were released at different rates from the four reference ST products.
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Affiliation(s)
- Siqi Guan
- Kentucky Tobacco Research and Development Center, University of Kentucky, 1401 University Dr., Lexington, KY 40546, USA
| | - Lowell Bush
- Kentucky Tobacco Research and Development Center, University of Kentucky, 1401 University Dr., Lexington, KY 40546, USA
| | - Huihua Ji
- Kentucky Tobacco Research and Development Center, University of Kentucky, 1401 University Dr., Lexington, KY 40546, USA
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6
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Huang J, Xu Z, Teh BM, Zhou C, Yuan Z, Shi Y, Shen Y. Construction of a necroptosis-related lncRNA signature to predict the prognosis and immune microenvironment of head and neck squamous cell carcinoma. J Clin Lab Anal 2022; 36:e24480. [PMID: 35522142 PMCID: PMC9169178 DOI: 10.1002/jcla.24480] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 01/05/2023] Open
Abstract
Background Previous studies have determined that necroptosis‐related genes are potential biomarkers in head and neck squamous cell carcinoma (HNSCC). Herein, we established a novel risk model based on necroptosis‐related lncRNAs (nrlncRNAs) to predict the prognosis of HNSCC patients. Methods Transcriptome and related information were obtained from TCGA database, and an nrlncRNA signature was established based on univariate Cox analysis and least absolute shrinkage and selection operator Cox regression. Kaplan–Meier analysis and time‐dependent receiver operating characteristic (ROC) analysis were used to evaluate the model, and a nomogram for survival prediction was established. Gene set enrichment analysis, immune analysis, drug sensitivity analysis, correlation with N6‐methylandenosin (m6A), and tumor stemness analysis were performed. Furthermore, the entire set was divided into two clusters for further discussion. Results A novel signature was established with six nrlncRNAs. The areas under the ROC curves (AUCs) for 1‐, 3‐, and 5‐year overall survival (OS) were 0.699, 0.686, and 0.645, respectively. Patients in low‐risk group and cluster 2 had a better prognosis, more immune cell infiltration, higher immune function activity, and higher immune scores; however, patients in high‐risk group and cluster 1 were more sensitive to chemotherapy. Moreover, the risk score had negative correlation with m6A‐related gene expression and tumor stemness. Conclusion According to this study, we constructed a novel signature with nrlncRNA pairs to predict the survival of HNSCC patients and guide immunotherapy and chemotherapy. This may possibly promote the development of individualized and precise treatment for HNSCC patients.
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Affiliation(s)
- Juntao Huang
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, China.,School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Ziqian Xu
- Department of Dermatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bing Mei Teh
- Department of Ear Nose and Throat, Head and Neck Surgery, Eastern Health, Box Hill, Victoria, Australia.,Department of Otolaryngology, Head and Neck Surgery, Monash Health, Clayton, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Chongchang Zhou
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, China.,School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Zhechen Yuan
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, China.,School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yunbin Shi
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yi Shen
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, China.,School of Medicine, Ningbo University, Ningbo, Zhejiang, China
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7
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A Novel Overall Survival Nomogram Prediction of Secondary Primary Malignancies after Hypopharyngeal Cancer: A Population-Based Study. JOURNAL OF ONCOLOGY 2022; 2022:4681794. [PMID: 35528241 PMCID: PMC9073552 DOI: 10.1155/2022/4681794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/23/2022] [Indexed: 12/05/2022]
Abstract
Objectives We aimed to construct a nomogram for predicting the overall survival (OS) of patients with secondary primary malignancies (SPMs) after hypopharyngeal cancer (HPC). Methods 613 HPC patients were included in the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2018, which were divided into training and validation cohorts. The least absolute shrinkage and selection operation (LASSO) and stepwise Cox regression were used to determine the variables by which a nomogram model was established. Results After the LASSO and stepwise Cox regression analysis, the age, year of diagnosis, sites of SPMs, SEER stage of SPMs, surgery for SPMs, and radiotherapy for SPMs were included for model establishment. The ROC curve showed good discrimination for the 3- and 5-year AUC values in the training (0.774 and 0.779, respectively) and validation (0.758 and 0.763, respectively) cohorts. The calibration curve indicated good prognostic accuracy, especially in the 5-year survival prediction for this model. The DCA also demonstrated clinical efficacy over a wide range of threshold probabilities. Lastly, the risk group classified by the individual nomogram values showed significantly different survival outcomes in both training and validation cohorts. Conclusions We constructed a nomogram to predict the OS of SPMs after HPC with good clinical values.
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8
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Chauhan R, Trivedi V, Rani R, Singh U. A Study of Head and Neck Cancer Patients with Reference to Tobacco Use, Gender, and Subsite Distribution. South Asian J Cancer 2022; 11:46-51. [PMID: 35833037 PMCID: PMC9273320 DOI: 10.1055/s-0041-1740601] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Context
Head and neck cancer (HNC) is very common in India, constituting 30% of all the cancers because of the widespread use of tobacco across India. The prevalence and pattern of tobacco use vary in different regions and states of the country. Although predominantly seen in males, studies have reported that the male-to-female ratio varies worldwide and also by anatomical subsite.
Aims
This study was done with an aim to determine the difference in pattern and prevalence of tobacco use in male and female patients with HNCs and compare them with different subsites' involvement in our region.
Methods and Materials
This is a retrospective analysis of 500 consecutive biopsy-proven HNC patients from a large comprehensive cancer hospital from Bihar during the period of January 2019 to June 2019. Data collected for the study included age, gender, site of the disease, and use of tobacco. The categorical data were analyzed by a chi-square test using SPSS (version 16).
Results
Our study showed a male-to-female ratio of 8.43:1 with tobacco addiction in 84.40% patients. Smokeless tobacco was used by 52.20%, combustible form by 12.80%, and both by 19.40% of the patients. Tobacco use was seen in 87.25% of male patients as compared with only 60.38% of female patients (
p
-value = 0.0001). Oral cavity cancer was seen in 60.85% of male patients and 37.74% of female patients (
p
-value = 0.0012), whereas oropharyngeal cancer was seen in only 11.63% of male patients as compared with 25.83% of female patients (
p
-value = 0.0008). The subsite analysis showed that in patients with oral cavity cancers, no addiction was found in only 10.29% of male patients as compared with 30% of the female patients (
p
-value = 0.008).
Conclusions
Our study confirms a high prevalence of tobacco use among HNC patients. So, we need to continue our efforts to create awareness against tobacco use. Besides, there is also a need for more studies to look into other etiological factors among nontobacco users.
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Affiliation(s)
- Richa Chauhan
- Department of Radiotherapy, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - Vinita Trivedi
- Department of Radiotherapy, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - Rita Rani
- Department of Radiotherapy, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - Usha Singh
- Department of Radiotherapy, Mahavir Cancer Sansthan, Patna, Bihar, India
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9
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Livingstone-Banks J, Siddiqui F, Croucher R, Mehrotra R, Vidyasagaran A, Siddiqi K. Interventions for smokeless tobacco use cessation. Cochrane Database Syst Rev 2022; 2022. [PMCID: PMC8772273 DOI: 10.1002/14651858.cd015314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Affiliation(s)
| | - Faraz Siddiqui
- Department of Health Sciences and Hull York Medical School; York University; York UK
| | - Ray Croucher
- Department of Health Sciences and Hull York Medical School; York University; York UK
| | - Ravi Mehrotra
- Department of Health Sciences and Hull York Medical School; York University; York UK
- Centre for Health Policy and Innovation; New Delhi India
| | | | - Kamran Siddiqi
- Department of Health Sciences and Hull York Medical School; York University; York UK
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10
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Deneuve S, Pérol O, Dantony E, Guizard AV, Bossard N, Virard F, Fervers B. Diverging incidence trends of oral tongue cancer compared to other head and neck cancers in young adults in France. Int J Cancer 2021; 150:1301-1309. [PMID: 34889463 DOI: 10.1002/ijc.33896] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/18/2021] [Accepted: 11/02/2021] [Indexed: 01/02/2023]
Abstract
While head and neck cancer incidence decreased worldwide due to reduced tobacco and alcohol consumption, oral tongue cancer (OTC) incidence has been reported to be increasing in several countries. Our study examines the incidence trends of OTC in France from 1990 to 2018, globally and by age; and compares the incidence trends with the evolution of the incidence of other human papilloma virus-unrelated head and neck squamous cell carcinoma, that is, cancers of the remaining subsites of the oral cavity (RSOCC) and laryngeal cancers for the period 1990 to 2018. World age-standardized incidence rates of oral tongue cancers (C02), cancers of the remaining subsites of the oral cavity (RSOCC, C03-06) and laryngeal cancers (C32) were estimated using the French National Network of Cancer Registries for the period 1990 to 2018. Trends in national incidence rates were estimated from a mixed-effect Poisson model including age and year effects using penalized splines and a district-random effect. In women aged 30 and 40, a significant increase in OTC incidence was observed, while ROSCC showed a nonsignificant incidence decrease. In young men aged 25, a marginally significant increase of OTC incidence years was observed, while incidence rates of RSOCC significantly declined. The results suggest a tendency towards diverging incidence trends for OTC compared to RSOCC and laryngeal cancer in young adults. The observed trends may reflect changes in underlying exposures or emerging exposures not yet identified, and stress the need to further investigate the etiology of oral tongue cancers.
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Affiliation(s)
- Sophie Deneuve
- Department of Surgical Oncology, Centre Léon Bérard, Lyon, France.,INSERM 1296 Unit, Radiations: Defense, Health and Environment, Centre Léon Bérard, Lyon, France
| | - Olivia Pérol
- INSERM 1296 Unit, Radiations: Defense, Health and Environment, Centre Léon Bérard, Lyon, France.,Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
| | - Emmanuelle Dantony
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Anne-Valérie Guizard
- Calvados General Tumor Registry, Centre Francois Baclesse, Caen, France.,U1086 INSERM-UCN "ANTICIPE", Centre Francois Baclesse, Caen, France
| | - Nadine Bossard
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - François Virard
- Cancer Research Center of Lyon, INSERM 1052, Claude Bernard University, Lyon, France.,Faculté d'Odontologie, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | - Béatrice Fervers
- INSERM 1296 Unit, Radiations: Defense, Health and Environment, Centre Léon Bérard, Lyon, France.,Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
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11
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Dawes K, Sampson L, Reimer R, Miller S, Philibert R, Andersen A. Epigenetic Analyses of Alcohol Consumption in Combustible and Non-Combustible Nicotine Product Users. EPIGENOMES 2021; 5:epigenomes5030018. [PMID: 34968367 PMCID: PMC8594674 DOI: 10.3390/epigenomes5030018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/18/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022] Open
Abstract
Alcohol and tobacco use are highly comorbid and exacerbate the associated morbidity and mortality of either substance alone. However, the relationship of alcohol consumption to the various forms of nicotine-containing products is not well understood. To improve this understanding, we examined the relationship of alcohol consumption to nicotine product use using self-report, cotinine, and two epigenetic biomarkers specific for smoking (cg05575921) and drinking (Alcohol T Scores (ATS)) in n = 424 subjects. Cigarette users had significantly higher ATS values than the other groups (p < 2.2 × 10−16). Using the objective biomarkers, the intensity of nicotine and alcohol consumption was correlated in both the cigarette and smokeless users (R = −0.66, p = 3.1 × 10−14; R2 = 0.61, p = 1.97 × 10−4). Building upon this idea, we used the objective nicotine biomarkers and age to build and test a Balanced Random Forest classification model for heavy alcohol consumption (ATS > 2.35). The model performed well with an AUC of 0.962, 89.3% sensitivity, and 85% specificity. We conclude that those who use non-combustible nicotine products drink significantly less than smokers, and cigarette and smokeless users drink more with heavier nicotine use. These findings further highlight the lack of informativeness of self-reported alcohol consumption and suggest given the public and private health burden of alcoholism, further research into whether using non-combustible nicotine products as a mode of treatment for dual users should be considered.
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Affiliation(s)
- Kelsey Dawes
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA; (L.S.); (R.P.); (A.A.)
- Behavioral Diagnostics LLC, Coralville, IA 52241, USA;
- Correspondence: ; Tel.: +1-319-361-2081
| | - Luke Sampson
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA; (L.S.); (R.P.); (A.A.)
| | - Rachel Reimer
- College of Public Health, Des Moines University, Des Moines, IA 50312, USA;
| | - Shelly Miller
- Behavioral Diagnostics LLC, Coralville, IA 52241, USA;
| | - Robert Philibert
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA; (L.S.); (R.P.); (A.A.)
- Behavioral Diagnostics LLC, Coralville, IA 52241, USA;
| | - Allan Andersen
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA; (L.S.); (R.P.); (A.A.)
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Hernandez AL, Karthik R, Sivasubramanian M, Raghavendran A, Lensing S, Lee JY, Abraham P, Mathai D, Palefsky JM. Prevalence of oral human papillomavirus infection among Indian HIV-positive men who have sex with men: a cross-sectional study. BMC Infect Dis 2021; 21:675. [PMID: 34247583 PMCID: PMC8274002 DOI: 10.1186/s12879-021-06301-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 06/09/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Oral human papillomavirus (HPV) infection has been causally linked to a subset of oropharyngeal cancers in Western populations, and both oropharyngeal cancer and oral HPV infection are increased among HIV-positive individuals. India has high incidences of oral and oropharyngeal cancers, and Indian HIV-positive men who have sex with men (MSM) may be at increased risk of developing oropharyngeal cancers. However, there is little information available on the prevalence of oral HPV in this population. METHODS We tested 302 HIV-positive Indian MSM for oral HPV infection using L1 HPV DNA PCR with probes specific for 29 types and a mixture of 10 additional types. CD4+ level and plasma HIV viral load (VL) were measured. Participants completed an interviewer-administered questionnaire including a sexual history. RESULTS The prevalence of oral HPV was 23.7% (95% CI: 19-29%) and 2.4% of participants had oncogenic HPV types. No participants had oral HPV type 16 (HPV-16) and the prevalence of other anogenital HPV types was low. Participants with higher CD4+ levels had reduced odds of having any oral HPV infection (OR: 3.1 [1.4-6.9]) in multivariable analyses. CONCLUSIONS This is the first report of oral HPV among Indian HIV-positive MSM. Our results show a high prevalence of oral HPV infection consistent with studies from Western populations. However, oncogenic anogenital HPV types were relatively uncommon in our study population. It is unknown what the impact of this distribution of oral HPV will be on oropharyngeal cancers. HIV-positive MSM in India should be monitored closely for oral and oropharyngeal pre-cancer and cancer.
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Affiliation(s)
- Alexandra L Hernandez
- Division of Infectious Diseases, Department of Medicine, University of California, Box 0654, 513 Parnassus Ave, Room S420, San Francisco, CA, 94143, USA.
- Public Health Program, College of Education and Health Sciences, Touro University, Vallejo, CA, USA.
| | - Rajiv Karthik
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | | | | | - Shelly Lensing
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jeannette Y Lee
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Priya Abraham
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | - Dilip Mathai
- Apollo Institute of Medical Sciences and Research, Hyderabad, India
| | - Joel M Palefsky
- Division of Infectious Diseases, Department of Medicine, University of California, Box 0654, 513 Parnassus Ave, Room S420, San Francisco, CA, 94143, USA
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Six Glycolysis-Related Genes as Prognostic Risk Markers Can Predict the Prognosis of Patients with Head and Neck Squamous Cell Carcinoma. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8824195. [PMID: 33628816 PMCID: PMC7889344 DOI: 10.1155/2021/8824195] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 01/10/2021] [Accepted: 01/15/2021] [Indexed: 02/06/2023]
Abstract
Objective Head and neck squamous cell carcinoma (HNSCC) is one of the worst-prognosis malignant tumors. This study used bioinformatic analysis of the transcriptome sequencing data of HNSCC and the patients' survival and clinical data to construct a prediction signature of glycolysis-related genes as the prognostic risk markers. Methods Gene expression profile data about HNSCC tissues (n = 498) and normal tissues in the head and neck (n = 44) were got from The Cancer Genome Atlas (TCGA), as well as patients' survival and clinical data. Then, we obtained core genes; their expression in head and neck squamous cell carcinoma tissues is significantly different from that in normal head and neck tissues. The predicted glycolysis-related genes are screened through univariate Cox regression analysis, and then, the prognostic risk markers were constructed through further correction of multivariate Cox regression analysis. The Kaplan-Meier curve and receiver operating characteristic curve are used to analyze the potential value of these risk markers in diagnosis and prognosis. We also evaluated that the glycolysis-related prognostic risk markers composed of 6 oncogenes are correlated with clinical features, such as age, gender, grade, and clinical stage of the tumor, by univariate and multivariate Cox regression analyses. Results Differentially expressed glycolytic genes in HNSCC tissues and normal head and neck tissues were screened from TCGA databases using the bioinformatic method. We confirmed a set of six glycolytic genes that were significantly associated with OS in the test series. According to our analysis, the prognostic risk markers composed of HPRT1, STC2, PLCB3, GPR87, PYGL, and SLC5A12 may be an independent risk factor for the prognosis of HNSCC. Conclusions Through this analysis, we constructed new prognostic risk markers related to glycolysis as a prognostic risk marker for patients with HNSCC and provided new ideas and molecular targets for the research and individualized treatment of HNSCC.
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Yin Y, Li F, Tong L, Chen C, Yuan B. Effects of in IL-1B/IL-1RN variants on the susceptibility to head and neck cancer in a chinese Han population. Cancer Cell Int 2021; 21:59. [PMID: 33472637 PMCID: PMC7816368 DOI: 10.1186/s12935-021-01750-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/02/2021] [Indexed: 02/01/2023] Open
Abstract
Background The study aimed to evaluate the relationship of IL-1B/IL-1RN polymorphisms to the predisposition of head and neck cancer (HNC) in a Chinese Han population. Methods Nine single-nucleotide polymorphisms (SNPs) in IL-1B/IL-1RN were genotyped based on Agena MassARRAY platform. Logistic regression models were used to analyze the genetic association between these SNPs and HNC risk by calculating odds ratios (ORs) and 95% confidence intervals (CI). Haplotype analysis were performed using Haploview program and logistic regression model. Results The genetic association between rs1143643 in IL-1B and the higher risk of HNC was found (OR = 1.23, 95% CI 1.04–1.46) in the overall. IL-1RN rs17042888 was related to a reduced risk of HNC in the subjects aged > 46 years (OR = 0.70, 95% CI: 0.50–0.98) and in females (OR = 0.71, 95% CI 0.52–0.98), while rs1143643 increased the predisposition of HNC among females (OR = 1.76, 95% CI 1.13–2.74). Furthermore, rs1143643 had an increased susceptibility to thyroid carcinoma (OR = 1.61, 95% CI 1.10–2.34). Moreover, compared with stage I–II, the frequency of IL-1RN rs452204-AG genotype was lower in patients with stage III–IV. Conclusions IL-1B (rs1143643) and IL-1RN (rs17042888 and rs452204) polymorphisms might be related to the individual susceptibility of HNC in the Chinese Han population. These results might help to improve the understanding of IL-1B and IL-1RN genes in the occurrence of HNC. Supplementary Information The online version contains supplementary material available at 10.1186/s12935-021-01750-0.
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Affiliation(s)
- Yanhai Yin
- Department of Nuclear medicine, Hainan Affiliated Hospital of Hainan Medical University, Hainan general Hospital, Haikou, Hainan Province, China
| | - Fen Li
- Department of Nuclear medicine, Hainan Affiliated Hospital of Hainan Medical University, Hainan general Hospital, Haikou, Hainan Province, China
| | - Liangqian Tong
- Department of Nuclear medicine, Haikou general Hospital, Haikou, Hainan Province, China
| | - Chunru Chen
- Department of Nuclear medicine, Hainan Affiliated Hospital of Hainan Medical University, Hainan general Hospital, Haikou, Hainan Province, China
| | - Bo Yuan
- Department of General surgery, Hainan Affiliated Hospital of Hainan Medical University, Hainan general Hospital, #19 Xiuhua Road, Xiuying District, Haikou, Hainan Province, 570311, China.
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Fathima T, Arumugam P, AS SG, Priyadharsini JV. Decoding the Genetic Alterations in Genes of DNMT Family (DNA Methyl-Transferase) and their Association with Head and Neck Squamous Cell Carcinoma. Asian Pac J Cancer Prev 2020; 21:3605-3612. [PMID: 33369458 PMCID: PMC8046301 DOI: 10.31557/apjcp.2020.21.12.3605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/26/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Epigenetic modifications are gaining focus due to their indirect association with tumorigenesis. DNA methylation plays a prime role in regulation of gene expression. Any aberrations in this gene family may lead to chromosomal instability and increased magnitude of tumour progression. In line with the above fact, the present study has been designed to identify genetic alterations in the genes of the DNMT (DNA methyl-transferase) family among head and neck squamous cell carcinoma patients (HNSCC). METHODS The present study follows an observational design employing computational tools for analysis. The TCGA-Firehose Legacy data was assessed using the cBioportal database. The dataset comprised of 530 samples from HNSCC patients which were assessed for genetic alterations in the DNMT family. Furthermore, the protein stability analysis and pathogenicity of the mutations were assessed using I-Mutant Suite and PROVEAN tools. RESULTS Almost all genes of the DNMT family harboured gene amplification. The TRDMT1 and DNMT3L genes showed deep deletions. Apart from these several non-synonymous, truncating and splice-site mutations were also documented. Protein stability and pathogenicity analysis revealed that majority of the mutations were found to decrease the stability and impose pathogenicity. Upon probing for reported mutations using gnomAD database, around six reference single nucleotide polymorphisms were identified which were found to exhibit a minor allele frequency less than 0.01. CONCLUSIONS Screening of an exhaustive collection of patient's samples could provide immense knowledge about the disease pathogenesis and identification of therapeutic leads. The variants identified in the present study could be used as diagnostic markers. However, further experimental analysis through genotyping assay is warranted to validate the present findings. .
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Affiliation(s)
- Tahreem Fathima
- Saveetha Dental College, Velappanchavadi, Poonamallee High Road, India.
| | - Paramasivam Arumugam
- Dental Research Cell, Saveetha Dental College, Poonamallee High Road, Chennai-77, India.
| | - Smiline Girija AS
- Department of Microbiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India.
| | - J Vijayashree Priyadharsini
- Biomedical Research Unit and Laboratory Animal Centre - Dental Research Cell, Saveetha Dental College and Hospitals, Chennai-77, India.
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Bover Manderski MT, Black K, Udasin IG, Black TM, Steinberg MB, Giuliano AR, Luft BJ, Harrison D, Crane MA, Moline J, Passannante MR, Ohman Strickland P, Dasaro CR, Lucchini RG, Todd AC, Graber JM. Retrospective Assessment of Risk Factors for Head and Neck Cancer Among World Trade Center General Responders. Front Public Health 2020; 8:488057. [PMID: 33330296 PMCID: PMC7734028 DOI: 10.3389/fpubh.2020.488057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/04/2020] [Indexed: 12/22/2022] Open
Abstract
Objective: To assess the reliability of a questionnaire designed to reconstruct risk factors for head and neck cancer relative to the 9/11 World Trade Center (WTC) response and over the lifetime. Methods: As part of a nested case-control study, 200 WTC Health Program (WTCHP) General Responder Cohort (GRC) members completed a newly-developed study questionnaire via telephone (with a trained interviewer) or online (self-administered). We assessed agreement between measures of tobacco and alcohol use in our questionnaire results and data collected previously during WTCHP-GRC monitoring visits using Cohens Kappa (κ) and intraclass correlation coefficient (ICC) for categorical and continuous measures, respectively. We compared agreement by disease status, survey mode, and year of WTCHP enrollment. Results: We observed high agreement between measures of lifetime, pre-WTC, and post-WTC smoking prevalence (all κ > 0.85) and smoking duration (all ICC > 0.84). There was moderate agreement between measures of smoking frequency (ICC: 0.61-0.73). Agreement between measures of smoking frequency, but not duration, differed by disease status, and agreement between smoking measures was higher for participants who completed our survey by phone than by web. Among cases, there were no differences based on enrollment in the WTCHP before or after diagnosis. Conclusion: Agreement between measures was generally high, although potential reporting bias and a mode effect that should be considered when interpreting analyses of self-reported data in this population; however differential misclassification appears to be minimal. Our questionnaire may be useful for future studies examining similar behavioral risk factors among disaster-exposed populations.
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Affiliation(s)
- Michelle T. Bover Manderski
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States
| | - Kathleen Black
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Iris G. Udasin
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Taylor M. Black
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Michael B. Steinberg
- Division of General Internal Medicine, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Anna R. Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States
| | - Benjamin J. Luft
- Department of Medicine, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - Denise Harrison
- Department of Environmental Medicine, Bellevue Hospital Center/New York University School of Medicine, New York, NY, United States
| | - Michael A. Crane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jacqueline Moline
- Department of Occupational Medicine, Epidemiology and Prevention, Hofstra Northwell School of Medicine at Hofstra University, Hempstead, NY, United States
| | - Marian R. Passannante
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States
| | - Pamela Ohman Strickland
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States
| | - Christopher R. Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Roberto G. Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Andrew C. Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Judith M. Graber
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
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Siddiqi K, Husain S, Vidyasagaran A, Readshaw A, Mishu MP, Sheikh A. Global burden of disease due to smokeless tobacco consumption in adults: an updated analysis of data from 127 countries. BMC Med 2020; 18:222. [PMID: 32782007 PMCID: PMC7422596 DOI: 10.1186/s12916-020-01677-9] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/23/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Smokeless tobacco (ST) is consumed by more than 300 million people worldwide. The distribution, determinants and health risks of ST differ from that of smoking; hence, there is a need to highlight its distinct health impact. We present the latest estimates of the global burden of disease due to ST use. METHODS The ST-related disease burden was estimated for all countries reporting its use among adults. Using systematic searches, we first identified country-specific prevalence of ST use in men and women. We then revised our previously published disease risk estimates for oral, pharyngeal and oesophageal cancers and cardiovascular diseases by updating our systematic reviews and meta-analyses of observational studies. The updated country-specific prevalence of ST and disease risk estimates, including data up to 2019, allowed us to revise the population attributable fraction (PAF) for ST for each country. Finally, we estimated the disease burden attributable to ST for each country as a proportion of the DALYs lost and deaths reported in the 2017 Global Burden of Disease study. RESULTS ST use in adults was reported in 127 countries; the highest rates of consumption were in South and Southeast Asia. The risk estimates for cancers were also highest in this region. In 2017, at least 2.5 million DALYs and 90,791 lives were lost across the globe due to oral, pharyngeal and oesophageal cancers that can be attributed to ST. Based on risk estimates obtained from the INTERHEART study, over 6 million DALYs and 258,006 lives were lost from ischaemic heart disease that can be attributed to ST. Three-quarters of the ST-related disease burden was among men. Geographically, > 85% of the ST-related burden was in South and Southeast Asia, India accounting for 70%, Pakistan for 7% and Bangladesh for 5% DALYs lost. CONCLUSIONS ST is used across the globe and poses a major public health threat predominantly in South and Southeast Asia. While our disease risk estimates are based on a limited evidence of modest quality, the likely ST-related disease burden is substantial. In high-burden countries, ST use needs to be regulated through comprehensive implementation of the World Health Organization Framework Convention for Tobacco Control.
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Affiliation(s)
- Kamran Siddiqi
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK. .,Hull York Medical School, University of York, Heslington, York, YO10 5DD, UK.
| | - Scheherazade Husain
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
| | - Aishwarya Vidyasagaran
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
| | - Anne Readshaw
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
| | - Masuma Pervin Mishu
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Medical School Doorway 3, Teviot Place, Edinburgh, EH8 9AG, UK
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Papenberg BW, Allen JL, Markwell SM, Interval ET, Montague PA, Johnson CJ, Weed SA. Disparate survival of late-stage male oropharyngeal cancer in Appalachia. Sci Rep 2020; 10:11612. [PMID: 32669588 PMCID: PMC7363863 DOI: 10.1038/s41598-020-68380-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/17/2020] [Indexed: 02/07/2023] Open
Abstract
The United States Appalachian region harbors a higher cancer burden than the rest of the nation, with disparate incidence of head and neck squamous cell carcinomas (HNSCC), including oral cavity and pharynx (OC/P) cancers. Whether elevated HNSCC incidence generates survival disparities within Appalachia is unknown. To address this, HNSCC survival data for 259,737 tumors from the North American Association for Central Cancer Registries 2007-2013 cohort were evaluated, with age-adjusted relative survival (RS) calculated based on staging, race, sex, and Appalachian residence. Tobacco use, a primary HNSCC risk factor, was evaluated through the Behavioral Risk Factor Surveillance System from Appalachian states. Decreased OC/P RS was found in stage IV Appalachian white males within a subset of states. The survival disparity was confined to human papillomavirus (HPV)-associated oropharyngeal cancers, specifically the oropharynx subsite. This correlated with significantly higher smoking and male smokeless tobacco use in most Appalachian disparity states. Lower survival of Appalachian males with advanced-stage HPV-associated oropharyngeal cancers suggests pervasive tobacco consumption likely generates more aggressive tumors at HPV-associated oropharynx subsites than national averages. Comprehensive tobacco and HPV status should therefore be evaluated prior to considering treatment de-intensification regimens for HPV-associated oropharyngeal cancers in populations with high tobacco consumption.
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Affiliation(s)
- Brenen W Papenberg
- Department of Biochemistry, Program in Cancer Cell Biology, West Virginia University Cancer Institute, West Virginia University, P.O. Box 9300, Morgantown, WV, 26506, USA
| | - Jessica L Allen
- Department of Biochemistry, Program in Cancer Cell Biology, West Virginia University Cancer Institute, West Virginia University, P.O. Box 9300, Morgantown, WV, 26506, USA
| | - Steven M Markwell
- Department of Biochemistry, Program in Cancer Cell Biology, West Virginia University Cancer Institute, West Virginia University, P.O. Box 9300, Morgantown, WV, 26506, USA
| | - Erik T Interval
- Department of Otolaryngology, Head and Neck Surgery, West Virginia University, Morgantown, WV, 26506, USA
| | - Phillip A Montague
- Department of Otolaryngology, Head and Neck Surgery, West Virginia University, Morgantown, WV, 26506, USA
| | | | - Scott A Weed
- Department of Biochemistry, Program in Cancer Cell Biology, West Virginia University Cancer Institute, West Virginia University, P.O. Box 9300, Morgantown, WV, 26506, USA.
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Nasrin S, Chen G, Watson CJW, Lazarus P. Comparison of tobacco-specific nitrosamine levels in smokeless tobacco products: High levels in products from Bangladesh. PLoS One 2020; 15:e0233111. [PMID: 32453764 PMCID: PMC7250445 DOI: 10.1371/journal.pone.0233111] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 04/28/2020] [Indexed: 12/24/2022] Open
Abstract
Bangladesh exhibits the second highest rate of smokeless tobacco (SLT) product usage in the world, and this has been associated with the high upper aerodigestive tract cancer incidence in this country. The goal of the present study was to examine the levels of the highly carcinogenic tobacco-specific nitrosamines (TSNAs) in Bangladeshi SLT products and compare these levels to that observed in SLT brands from southeast Asia and the USA. The levels of TSNAs and nicotine were determined by LC-MS/MS in twenty-eight SLT brands and several tobacco additives from Bangladesh, as well as several SLT brands from India, Pakistan and the USA. The levels of N-nitrosonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N-nitrosoanatabine (NAT) and N-nitrosoanabasine (NAB) in Bangladeshi SLT brands ranged from 1.1-59, 0.15-34, 0.79-45, and 0.037-13 μg/g SLT powder, respectively. The mean levels of the highly carcinogenic TSNAs (NNN+NNK) were 7.4-, 2.4-, and 63-fold higher in Bangladeshi SLT products as compared to SLT brands from the USA, India and Pakistan, respectively; these trends were also observed for NAT and NAB. Similar mean levels of nicotine were observed in the Bangladeshi brands (31 mg/g powder) versus brands from the USA (25 mg/g powder) and India (20 mg/g powder); they were 3-fold higher than brands from Pakistan (10 mg/g powder). Gul SLT brands exhibited the highest pH and the highest levels of unprotonated nicotine. The high levels of TSNAs in Bangladeshi SLT brands may be an important factor contributing to the high rates of upper aerodigestive tract cancer in Bangladesh.
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Affiliation(s)
- Shamema Nasrin
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington, United States of America
| | - Gang Chen
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington, United States of America
| | - Christy J. W. Watson
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington, United States of America
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington, United States of America
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Asthana S, Labani S, Kailash U, Sinha DN, Mehrotra R. Association of Smokeless Tobacco Use and Oral Cancer: A Systematic Global Review and Meta-Analysis. Nicotine Tob Res 2020; 21:1162-1171. [PMID: 29790998 DOI: 10.1093/ntr/nty074] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 04/12/2018] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Smokeless tobacco products have been linked to precancerous and cancers of oral cavity for long. Evidence was available on the association between smokeless tobacco (SLT) products and oral cancers at regional but not at global level. Present meta-analysis is aimed to evaluate the risk of oral cancer with the use of SLT products among "ever" versus "never" users. METHOD Studies published for the period (1960-2016) are retrieved using Pubmed, Indmed, EMBASE, and Google Scholar search engines for the subject "ever" versus "never" users of SLT products and estimated the risk association with oral cancer. Summary odds ratios (relative risk) are estimated and meta-analysis was performed using random-effects model. RESULTS Thirty-seven studies from four of six WHO regions, Southeast Asia region (SEAR), the Eastern Mediterranean Region (EMR), Europe, and region of Americas (North and South) are included in the analysis. Significant risk with SLT products with oral cancer was found for SEAR (4.44, 95% CI = 3.51 to 5.61) and for EMR (1.28, 95% CI = 1.04 to 1.56). Significantly higher risk (p < .001) was found for females (5.83, 95% CI = 2.93 to 11.58). Product wise analysis for different SLT products revealed various levels of risk viz. gutkha (8.67, 95% CI = 3.59 to 20.93), pan tobacco / betel liquid (7.18, 95% CI = 5.48 to 9.41), oral snuff (4.18, 50% CI = 2.37 to 7.38), Mainpuri tobacco (3.32, 95% CI = 1.32 to 8.36), and snus (0.86, 95% CI = 0.58 to 1.29). CONCLUSION A significant positive association was observed between SLT use and the risk of oral cancer, in SEAR, EMRs, and among women users. IMPLICATIONS The present meta-analysis demonstrates SLT product use and the risk of oral cancer at global level. Moreover, the present analysis provided data on the risk associated with individual SLT product. The results fulfil the gap in the data on independent effect of individual SLT product use on the outcome of oral cancer at global level, conclusively. Chewing SLT products was associated with higher risk of oral cancer than other types of SLT. This can serve as a useful tool for policy makers in forming strict policies in controlling SLT menace. Hence, we propose that in addition to smoking, efforts should be directed towards SLT product cessation as well in reducing oral cancer incidence.
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Affiliation(s)
- Smita Asthana
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Cancer Prevention and Research, Formerly Institute of Cytology and Preventive Oncology, Noida, Uttar Pradesh, India
| | - Satyanarayana Labani
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Cancer Prevention and Research, Formerly Institute of Cytology and Preventive Oncology, Noida, Uttar Pradesh, India
| | - Uma Kailash
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Cancer Prevention and Research, Formerly Institute of Cytology and Preventive Oncology, Noida, Uttar Pradesh, India
| | - Dhirendra N Sinha
- Consultant, WHO FCTC Global Knowledge Hub on Smokeless Tobacco, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Ravi Mehrotra
- ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
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Chang CP, Siwakoti B, Sapkota A, Gautam DK, Lee YCA, Monroe M, Hashibe M. Tobacco smoking, chewing habits, alcohol drinking and the risk of head and neck cancer in Nepal. Int J Cancer 2019; 147:866-875. [PMID: 31837000 DOI: 10.1002/ijc.32823] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 11/14/2019] [Accepted: 11/29/2019] [Indexed: 12/27/2022]
Abstract
Although tobacco smoking, pan chewing and alcohol drinking are important risk factors for head and neck cancer (HNC), the HNC risks conferred by products available in Nepal for these habits are unknown. We assessed the associations of tobacco smoking, chewing habits, and alcohol drinking with HNC risk in Nepal. A case-control study was conducted in Nepal with 549 incident HNC cases and 601 controls. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression adjusting for potential confounders. We observed increased HNC risk for tobacco smoking (OR: 1.54; 95% CI: 1.14, 2.06), chewing habits (OR: 2.39; 95% CI: 1.77, 3.23), and alcohol drinking (OR: 1.57; 95% CI: 1.14, 2.18). The population attributable fraction (PAF) was 24.3% for tobacco smoking, 39.9% for chewing habits and 23.0% for alcohol drinking. Tobacco smoking, chewing habits, and alcohol drinking might be responsible for 85.3% of HNC cases. Individuals who smoked tobacco, chewed products and drank alcohol had a 13-fold increase in HNC risk (OR: 12.83; 95% CI: 6.91, 23.81) compared to individuals who did not have any of these habits. Both high frequency and long duration of these habits were strong risk factors for HNC among the Nepalese with clear dose-response trends. Preventive strategies against starting these habits and support for quitting these habits are necessary to decrease the incidence of HNC in Nepal.
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Affiliation(s)
- Chun-Pin Chang
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT
| | - Bhola Siwakoti
- Department of Cancer Prevention, Control and Research, B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD
| | - Dej K Gautam
- ENT and Head and Neck Unit, B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT
| | - Marcus Monroe
- Division of Otolaryngology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT
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22
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Egbe CO, Londani M, Parry CDH, Myers B, Shuper PA, Nkosi S, Morojele NK. Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study. BMC Public Health 2019; 19:1684. [PMID: 31842834 PMCID: PMC6916073 DOI: 10.1186/s12889-019-8047-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/06/2019] [Indexed: 12/24/2022] Open
Abstract
Background People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink heavily. Methods Participants (n = 623) on antiretroviral therapy for HIV who reported heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C were recruited from six hospitals in Gauteng Province, South Africa. The Fagerström test was used to assess nicotine dependence. Chi Square tests and modified Poisson regression analyses were conducted to identify factors associated with tobacco use. Results Almost half of the participants reported ever smoking (44.0%; CI: 40.1–47.9) and about a quarter reported ever using snuff (25.5%; CI: 22.2–29.1). Current smokers and current snuff users comprised 27.3% (CI: 23.9–30.9) and 19.1% (CI: 16.2–22.3) of all participants respectively. Among current smokers, 37.9% (CI: 30.8–45.3) were moderately/highly dependent on nicotine. Current ‘any tobacco product users’ (ATPU: use cigarettes or snuff) were 45.4% (CI: 41.5–49.3) while 1.0% (CI: 0.4–2.0) currently used cigarettes and snuff. Adjusted regression analyses showed that, compared to males, females were less at risk of being: ever smokers (Relative Risk Ratio [RRR] = 0.33; CI: 0.27–0.41), current smokers (RRR = 0.18; CI: 0.12–0.25), and ATPU (RRR = 0.75; CI: 0.63–0.89) but were more at risk of ever snuff use (RRR = 5.23; CI: 3.31–8.25), or current snuff use (RRR = 26.19; CI: 8.32–82.40) than males. Ever snuff users (RRR = 1.32; CI: 1.03–1.70), current snuff users (RRR = 1.40; CI: 1.03–1.89) and ATPU (RRR = 1.27; CI: 1.07–1.51) were more at risk of reporting significant depressive symptoms. We found no significant associations between smoking status and years on ART and viral load. Conclusion There is a high prevalence of cigarette and snuff use among PLWH who drink heavily. Tobacco use cessation interventions tailored specifically for this population and according to their tobacco product of choice are urgently needed given their vulnerability to ill-health.
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Affiliation(s)
- Catherine O Egbe
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, No. 1 Soutpansberg Road, Pretoria, 0001, South Africa. .,Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
| | - Mukhethwa Londani
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, No. 1 Soutpansberg Road, Pretoria, 0001, South Africa
| | - Charles D H Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.,Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.,Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Paul A Shuper
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, No. 1 Soutpansberg Road, Pretoria, 0001, South Africa.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sebenzile Nkosi
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, No. 1 Soutpansberg Road, Pretoria, 0001, South Africa
| | - Neo K Morojele
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, No. 1 Soutpansberg Road, Pretoria, 0001, South Africa.,Department of Psychology, University of Johannesburg, Johannesburg, South Africa
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23
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Chang CP, Chang SC, Chuang SC, Berthiller J, Ferro G, Matsuo K, Wünsch-Filho V, Toporcov TN, de Carvalho MB, La Vecchia C, Olshan AF, Zevallos JP, Serraino D, Muscat J, Sturgis EM, Li G, Morgenstern H, Levi F, Dal Maso L, Smith E, Kelsey K, McClean M, Vaughan TL, Lazarus P, Ramroth H, Chen C, Schwartz SM, Winn DM, Bosetti C, Edefonti V, Garavello W, Negri E, Hayes RB, Purdue MP, Boccia S, Cadoni G, Shangina O, Koifman R, Curado MP, Vilensky M, Swiatkowska B, Herrero R, Franceschi S, Benhamou S, Fernandez L, Menezes AMB, Daudt AW, Mates D, Schantz S, Yu GP, Lissowska J, Brenner H, Fabianova E, Rudnai P, Brennan P, Boffetta P, Zhang ZF, Hashibe M, Lee YCA. Age at start of using tobacco on the risk of head and neck cancer: Pooled analysis in the International Head and Neck Cancer Epidemiology Consortium (INHANCE). Cancer Epidemiol 2019; 63:101615. [PMID: 31586822 PMCID: PMC10072232 DOI: 10.1016/j.canep.2019.101615] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Tobacco use is a well-established risk factor for head and neck cancer (HNC). However, less is known about the potential impact of exposure to tobacco at an early age on HNC risk. METHODS We analyzed individual-level data on ever tobacco smokers from 27 case-control studies (17,146 HNC cases and 17,449 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random-effects logistic regression models. RESULTS Without adjusting for tobacco packyears, we observed that younger age at starting tobacco use was associated with an increased HNC risk for ever smokers (OR<10 years vs. ≥30 years: 1.64, 95% CI: 1.35, 1.97). However, the observed association between age at starting tobacco use and HNC risk became null after adjusting for tobacco packyears (OR<10 years vs. ≥30 years: 0.97, 95% CI: 0.80, 1.19). In the stratified analyses on HNC subsites by tobacco packyears or years since quitting, no difference in the association between age at start and HNC risk was observed. CONCLUSIONS Results from this pooled analysis suggest that increased HNC risks observed with earlier age at starting tobacco smoking are largely due to longer duration and higher cumulative tobacco exposures.
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Affiliation(s)
- Chun-Pin Chang
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Shen-Chih Chang
- International Agency for Research on Cancer, Lyon, France; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| | - Shu-Chun Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Julien Berthiller
- International Agency for Research on Cancer, Lyon, France; Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, France
| | - Gilles Ferro
- International Agency for Research on Cancer, Lyon, France
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan; Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Victor Wünsch-Filho
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Tatiana N Toporcov
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC, United States
| | - Jose P Zevallos
- Division of Head and Neck Surgical Oncology, Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, Saint Louis, MO, United States
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Joshua Muscat
- Penn State College of Medicine, Hershey, PA, United States
| | - Erich M Sturgis
- University of Texas M. D. Anderson Cancer Center, Houston, TX, United States
| | - Guojun Li
- University of Texas M. D. Anderson Cancer Center, Houston, TX, United States
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health, and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, United States
| | - Fabio Levi
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Elaine Smith
- College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Karl Kelsey
- Brown University, Providence, RI, United States
| | | | - Thomas L Vaughan
- Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Philip Lazarus
- Washington State University College of Pharmacy, Spokane, WA, United States
| | | | - Chu Chen
- Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | | | - Deborah M Winn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Valeria Edefonti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Richard B Hayes
- Division of Epidemiology, New York University School of Medicine, New York, United States
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Stefania Boccia
- Institute of Public Health, Section of Hygiene, Universita Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - Gabriella Cadoni
- Department of Head and Neck Surgery, Institute of Clinical Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy; Istituto di Clinica Otorinolaringoiatrica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | | | - Rosalina Koifman
- Escola Nacional de Suade Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Marta Vilensky
- Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina
| | | | | | - Silvia Franceschi
- Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Simone Benhamou
- National Institute of Health and Medical Research, Inserm U1018, Villejuif, France
| | | | | | | | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | - Guo-Pei Yu
- Department of Otolaryngology, School of Medicine, New York Medical College, Valhalla, NY, United States
| | - Jolanta Lissowska
- The M. Skasodowska-Curie Memorial Cancer Center and Institute of Oncology, Dept. of Cancer Epidemiology and Prevention, Warsaw, Poland
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Peter Rudnai
- National Institute of Environmental Health, Budapest, Hungary
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States.
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24
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Kanwal M, Haider G, Zareef U, Saleem S. Addiction of tobacco chewing and smoking in the patients of head and neck squamous cell carcinoma: A descriptive epidemiological study in Pakistan. Pak J Med Sci 2019; 35:1712-1717. [PMID: 31777521 PMCID: PMC6861502 DOI: 10.12669/pjms.35.6.1309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective: The associated risk factors for the majority of patients with head and neck squamous cell carcinoma (HNSCC) are tobacco and betel nut abuse, while there also seems to be a rising proportion of patients who report no history of tobacco or betel nut usage. Therefore, objective of the study was to find out potential risk factors and demographics of HNSCC patients addicted to tobacco and/or betel nut, as well as non-addicted patients. Methods: This epidemiological study was conducted in Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, and Jinnah Postgraduate Medical Centre (JPMC) from January to December 2016. All subjects were participants in an epidemiological study of HNSCC. Demographics and clinical characteristics were obtained for 185 addicted and 26 non-addicted patients. Results: Non-addicted patients were more likely to be females (χ2=19.0, p<0.001) and were significantly younger than addicted patients (χ2=21.0, p<0.001). Addicted patients more likely belonged to a lower income group (χ2=14.4, p=0.006) and had a higher proportion of oral cancers (χ2=30.0, p<0.001). Almost all addicted females had oral cancers (97%), whereas more than half of the non-addicted females had oral cancers (53%). Conclusions: Addicted patients commonly have oral cavity cancers. This might be due to the habit of chewing tobacco and/or betel nut that addicted patients have. Non-addicted patients are commonly young females. It is likely that no single known factor is responsible for HNSCC in non-addicted patients, and several occupational exposure studies in future may be important to the etiology of non-addicted patients.
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Affiliation(s)
- Madiha Kanwal
- Madiha Kanwal, PhD Student. The Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan
| | - Ghulam Haider
- Ghulam Haider, MBBS, FCPS (Medicine), FCPS (Oncology), Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan
| | - Uzma Zareef
- Uzma Zareef, BDS, MCPS, (Oral & Maxillo-Facial Surgery), Liaquat College of Medicine and Dentistry (LCMD), Karachi, Pakistan
| | - Saima Saleem
- Saima Saleem, PhD. The Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan
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25
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Bover Manderski MT, Black K, Udasin IG, Giuliano AR, Steinberg MB, Ohman Strickland P, Black TM, Dasaro CR, Crane M, Harrison D, Moline J, Luft BJ, Passannante MR, Lucchini RG, Todd AC, Graber JM. Risk factors for head and neck cancer in the World Trade Center Health Program General Responder Cohort: results from a nested case-control study. Occup Environ Med 2019; 76:854-860. [PMID: 31515248 DOI: 10.1136/oemed-2019-105890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/13/2019] [Accepted: 08/29/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Head and neck cancers (HNCs) may be among the health consequences of involvement in the World Trade Center (WTC) response on and after 11 September 2001. We conducted a nested case-control study of WTC Health Program (WTCHP) general responders to examine the effects of WTC exposures and behavioural risk factors on HNC. METHODS We enrolled 64 cases and 136 controls, matched on age, sex and race/ethnicity within risk sets. We assessed tobacco and alcohol use, sexual activity, and occupational exposures prior to, during and after WTC exposure until case diagnosis via questionnaire. We obtained WTC exposure information (duration (first to last day), total days and location of work) from the WTCHP General Responder Data Center. We assessed associations with HNC, and interaction among exposures, using conditional logistic regression. RESULTS Responders in protective services versus other occupations had increased odds (OR: 2.51, 95% CI 1.09 to 5.82) of HNC. Among those in non-protective services occupations, arriving to the WTC effort on versus after 11 September 2001 was significantly associated with HNC (OR: 3.77, 95% CI 1.00 to 14.11). Duration of work was not significantly associated with HNC. Lifetime and post-WTC years of cigarette smoking and post-WTC number of sex partners were positively and significantly associated with HNC, while alcohol consumption was not. CONCLUSIONS These findings suggest opportunities for HNC risk factor mitigation (eg, smoking cessation, human papillomavirus vaccination) and contribute to a risk factor profile which may assist WTCHP clinicians with identifying high-risk responders and improve detection and treatment outcomes in this population.
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Affiliation(s)
- Michelle T Bover Manderski
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Kathleen Black
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Iris G Udasin
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Anna R Giuliano
- Department of Cancer Epidemiology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Michael B Steinberg
- Division of General Internal Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Pamela Ohman Strickland
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Taylor M Black
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Christopher R Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Michael Crane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Denise Harrison
- Department of Environmental Medicine, Bellevue Hospital Center, New York City, New York, USA
| | - Jacqueline Moline
- Department of Occupational Medicine, Epidemiology and Prevention, Hofstra Northwell School of Medicine at Hofstra University, Hempstead, New York, USA
| | - Benjamin J Luft
- Department of Medicine, Stony Brook University School of Medicine, Stony Brook, New York, USA
| | - Marian R Passannante
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Roberto G Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Andrew C Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Judith M Graber
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA.,Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
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26
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LC-MS/MS Analysis of Sugars, Alditols, and Humectants in Smokeless Tobacco Products. BEITRÄGE ZUR TABAKFORSCHUNG INTERNATIONAL 2019; 28:203-213. [PMID: 32327867 DOI: 10.2478/cttr-2019-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Globally, smokeless tobacco (ST) includes a wide array of chemically diverse products generally used in the oral cavity. Although ST has been widely investigated, this study was undertaken to determine the levels of sugars (mono- and di-saccharides), alditols, and humectants present in major ST categories/subcategories by using high performance liquid chromatography coupled with a triple quadrupole mass spectrometer (HPLC-MS/MS). The products studied included chewing tobacco (loose leaf, plug, twist), US moist snuff, Swedish snus, creamy snuff, dry snuff, dissolvable tobacco products, and tobacco-coated toothpicks. The highest mean sugar level was detected in chewing tobacco (9.3-27.5%, w/w), followed by dissolvable tobacco (2.1%); all other products were lower than 1%. Creamy snuff had the highest mean alditol levels (22.6%), followed by dissolvable tobacco (15.4%); all others had levels lower than 1%. The detected mean humectant levels ranged from non-detectable to 5.9%. This study demonstrates the broad chemical diversity among ST. This research may aid researchers and public health advocates investigating the exposures and risks of ST. [Beitr. Tabakforsch. Int. 28 (2019) 203-213].
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27
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McDermott JD, Bowles DW. Epidemiology of Head and Neck Squamous Cell Carcinomas: Impact on Staging and Prevention Strategies. Curr Treat Options Oncol 2019; 20:43. [PMID: 31011837 DOI: 10.1007/s11864-019-0650-5] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OPINION STATEMENT The epidemiology of head and neck squamous cell carcinoma (HNSCC) has shifted dramatically over the last 50 years, as smoking-related HNSCCs decrease in incidence while human papillomavirus (HPV)-related cancers rise. The shift in HNSCC risk factors has changed patient demographics, the distribution of affected anatomical subsites, and prognosis of this illness. As such, the medical community has responded by devising novel staging systems and prevention strategies. The medical community will require continued vigilance in reducing HNSCC traditional risks factors for HNSCC, such as cigarette use, and emerging risk like HPV infection.
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Affiliation(s)
- Jessica D McDermott
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, 12801 18 E. 17th Ave, MS 8117, Aurora, CO, 80045, USA
- Hematology/Oncology Section, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - Daniel W Bowles
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, 12801 18 E. 17th Ave, MS 8117, Aurora, CO, 80045, USA.
- Hematology/Oncology Section, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA.
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28
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Shahid N, Iqbal A, Siddiqui AJ, Shoaib M, Musharraf SG. Plasma metabolite profiling and chemometric analyses of tobacco snuff dippers and patients with oral cancer: Relationship between metabolic signatures. Head Neck 2018; 41:291-300. [PMID: 30548891 DOI: 10.1002/hed.25511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 04/30/2018] [Accepted: 08/15/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cancer of oral cavity is a seriously growing problem in many parts of the world. In Indian subcontinent, most of these cases have been attributed to the use of tobacco-related products. This study is focused on the identification of distinguishing metabolites of oral cancer in comparison with tobacco snuff dippers and healthy controls. METHODS A total of 234 plasma samples including 62 healthy controls, 81 tobacco snuff dippers, and 91 oral cancer samples were analyzed using mass spectrometry. RESULTS Twenty-nine of 3326 metabolites were found to distinguish among oral cancer, tobacco snuff dippers, and healthy controls using P-value ≤.001 and fold change ≥3. Prediction model was generated with an overall accuracy of 89.3%. Two metabolites, that is, stearyl alcohol and sucrose, can be used as predictive biomarkers showing progression of tobacco snuff dippers toward oral cancer. CONCLUSION The unique metabolite profile gives evidence of a strong correlation between tobacco snuff dipping and oral cancer.
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Affiliation(s)
- Najia Shahid
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Ayesha Iqbal
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Amna Jabbar Siddiqui
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Muhammad Shoaib
- Department of Chemistry, Bahauddin Zakariya University, Multan, Pakistan
| | - Syed Ghulam Musharraf
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan.,Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
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Gupta S, Gupta R, Sinha DN, Mehrotra R. Relationship between type of smokeless tobacco & risk of cancer: A systematic review. Indian J Med Res 2018; 148:56-76. [PMID: 30264755 PMCID: PMC6172923 DOI: 10.4103/ijmr.ijmr_2023_17] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background & objectives: Causative linkages of smokeless tobacco (SLT) use with oral potentially malignant disorders and cancers of oral cavity, oesophagus and pancreas have been reported. Published meta-analyses have provided pooled risk estimates for major cancers caused by SLT, both on global and regional levels. This systematic review was aimed at summarizing the available studies on occurrence and mortality risk of common cancers due to various SLT products. Methods: PubMed and Google Scholar databases were systematically searched from 1985 till January 2018 for observational studies on SLT and cancer. The included studies were evaluated and data were extracted and reviewed. Results: The review included 80 studies providing 121 risk estimates for various cancers. Majority of the studies from South-East Asian Region (SEAR) and Eastern Mediterranean Region (EMR) showed a significant positive association of SLT use with oral [odds ratio (OR) ranging from 1.48 to 27.4] and oesophageal cancers (OR between 2.06 and 12.8), while studies from European Region (EUR) reported a positive association with pancreatic cancer (OR between 1.6 and 2.1). Cancer-related mortality was evaluated in a few reports with higher risk of mortality for lung (OR between 2.0 and 9.1), cervical (OR 2.0) and prostate (OR 2.1) cancers. A wide variation was noted in the association of various cancers and specific SLT products based on their nature, methods of use and inherent toxicity. The majority of chewing tobacco products displayed higher risk for oral and oesophageal cancers while the same was not observed for snus. Interpretation & conclusions: This review emphasizes on the significantly positive association of SLT use with oral and oesophageal cancers in SEAR and EMR and pancreatic cancer in EUR. Mortality estimates for SLT-associated cancers need further analysis. Risk analysis for cancers of other sites in SLT users also requires multicentric well-designed studies.
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Affiliation(s)
- Sanjay Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Ruchika Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | | | - Ravi Mehrotra
- WHO FCTC Global Knowledge Hub for Smokeless Tobacco, ICMR-National Institute of Cancer Prevention & Research, Noida, India
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Kundu S, Ramshankar V, Verma AK, Thangaraj SV, Krishnamurthy A, Kumar R, Kannan R, Ghosh SK. Association of DFNA5, SYK, and NELL1 variants along with HPV infection in oral cancer among the prolonged tobacco-chewers. Tumour Biol 2018; 40:1010428318793023. [PMID: 30091681 DOI: 10.1177/1010428318793023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Southeast Asia, especially India, is well known for the highest use of smokeless tobacco. These products are known to induce oral squamous cell carcinoma. However, not all long-term tobacco-chewers develop oral squamous cell carcinoma. In addition, germline variants play a crucial role in susceptibility, prognosis, development, and progression of the disease. These prompted us to study the genetic susceptibility to oral squamous cell carcinoma among the long-term tobacco-chewers. Here, we presented a retrospective study on prolonged tobacco-chewers of Northeast India to identify the potential protective or risk-associated germline variants in tobacco-related oral squamous cell carcinoma along with HPV infection. Targeted re-sequencing (n = 60) of 170 genetic regions from 75 genes was carried out in Ion-PGM™ and validation (n = 116) of the observed variants was done using Sequenom iPLEX MassARRAY™ platform followed by polymerase chain reaction-based HPV genotyping and p16-immunohistochemistry study. Subsequently, estimation of population structure, different statistical and in silico approaches were undertaken. We identified one nonsense-mediated mRNA decay transcript variant in the DFNA5 region (rs2237306), associated with Benzo(a)pyrene, as a protective factor (odds ratio = 0.33; p = 0.009) and four harmful (odds ratio > 2.5; p < 0.05) intronic variants, rs182361, rs290974, and rs169724 in SYK and rs1670661 in NELL1 region, involved in genetic susceptibility to tobacco- and HPV-mediated oral oncogenesis. Among the oral squamous cell carcinoma patients, 12.6% (11/87) were HPV positive, out of which 45.5% (5/11) were HPV16-infected, 27.3% (3/11) were HPV18-infected, and 27.3% (3/11) had an infection of both subtypes. Multifactor dimensionality reduction analysis showed that the interactions among HPV and NELL1 variant rs1670661 with age and gender augmented the risk of both non-tobacco- and tobacco-related oral squamous cell carcinoma, respectively. These suggest that HPV infection may be one of the important risk factors for oral squamous cell carcinoma in this population. Finally, we newly report a DFNA5 variant probably conferring protection via nonsense-mediated mRNA decay pathway against tobacco-related oral squamous cell carcinoma. Thus, the analytical approach used here can be useful in predicting the population-specific significant variants associated with oral squamous cell carcinoma in any heterogeneous population.
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Affiliation(s)
- Sharbadeb Kundu
- 1 Department of Biotechnology, Assam University, Silchar, India
| | | | | | | | | | - Rajeev Kumar
- 5 Department of Molecular Oncology, Cachar Cancer Hospital & Research Centre, Silchar, India
| | - Ravi Kannan
- 5 Department of Molecular Oncology, Cachar Cancer Hospital & Research Centre, Silchar, India
| | - Sankar Kumar Ghosh
- 1 Department of Biotechnology, Assam University, Silchar, India.,6 University of Kalyani, Nadia, India
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Donald PM, Renjith G, Arora A. Tobacco Pouch Keratosis in a young individual: A brief description. J Indian Soc Periodontol 2018; 21:249-251. [PMID: 29440796 PMCID: PMC5803885 DOI: 10.4103/jisp.jisp_109_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Smokeless tobacco is used orally or nasally without burning tobacco. This is equally harmful as smokers due to the tobacco content and can cause oral cancer as well as systemic effects such as nicotinic dependence. Many other oral conditions have also been reported in association with smokeless tobacco. This paper presents features of tobacco pouch keratosis and aims to highlight the oral effects of smokeless tobacco, management, and guidelines for dentists in educating and counselling tobacco users.
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Affiliation(s)
- Preethy Mary Donald
- Department of Oral Medicine and Radiology, Melaka-Manipal Medical College, Malacca, Malaysia
| | - George Renjith
- Department of Oral Pathology, Melaka-Manipal Medical College, Malacca, Malaysia
| | - Ankita Arora
- Department of Pedodontics, Melaka-Manipal Medical College, Malacca, Malaysia
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Stanisce L, Levin K, Ahmad N, Koshkareva Y. Reviewing smokeless tobacco epidemiology, carcinogenesis, and cessation strategy for otolaryngologists. Laryngoscope 2018; 128:2067-2071. [PMID: 29427388 DOI: 10.1002/lary.27104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/OBJECTIVES We aimed to provide an otolaryngologist-targeted summary regarding the epidemiology, carcinogenesis, and cessation strategies for smokeless tobacco usage. STUDY DESIGN Evidence-based literature review. METHODS We reviewed the current evidence-based literature concerning trends in smokeless tobacco use, associations with neoplastic change, and therapeutic interventions to assist with sustained abstinence. In complement, we present an actual case of laryngeal squamous cell carcinoma in the setting of chronic tobacco-dentifrice usage in a lifelong nonsmoker. RESULTS This report provides a synopsis of epidemiological data and evidence-based recommendations for general, pharmaceutical, and behavioral cessation strategies. CONCLUSIONS Smokeless tobacco use continues to be prevalent among patients seen by otolaryngologists, particularly of various Indian and Southeast Asian descent. The data presented in this article will aid in the identification of at risk patients. The provided recommended cessation strategies will tool otolaryngologists for patient counseling and management, ultimately aimed at improving health outcomes. Laryngoscope, 128:2067-2071, 2018.
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Affiliation(s)
- Luke Stanisce
- Department of Biomedical Sciences, Cooper Medical School at Rowan University, Camden, New Jersey
| | - Kristin Levin
- Department of Biomedical Sciences, Cooper Medical School at Rowan University, Camden, New Jersey
| | - Nadir Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Cooper University Hospital, Camden, New Jersey, U.S.A
| | - Yekaterina Koshkareva
- Department of Otolaryngology-Head and Neck Surgery, Cooper University Hospital, Camden, New Jersey, U.S.A
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Al-Ak'hali MS, Halboub ES, Mujam OH, Alahmar NM, Jerah SA, Mutawwam FA. Salivary parameters among Arabian snuff (Shammah) users. Saudi Med J 2017; 38:1201-1206. [PMID: 29209668 PMCID: PMC5787630 DOI: 10.15537/smj.2017.12.20973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the salivary flow rate (SFR), pH, and buffer capacity (BC) among healthy shammah users (SU) in comparison with healthy non-shammah users (NSU). Methods: This case-control study was conducted at the College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia between March 2016 and May 2017. A sample of 27 SU and 30 NSU were recruited. Unstimulated saliva was collected and SFR, pH, and BC were determined. Dental health was assessed using the decay-missing-filled teeth (DMFT) index. Results: Shammah users were slightly older than NSU (28.9±6.9 versus 24.9±4.3 years). Salivary flow rate was not significantly different, but pH (6.68±0.46) and BC (5.7±2.07) were significantly lower in SU users than in NSU (7±0.37; p=0.002 versus 8.1±1.47; p less than 0.001). Conversely, the DMFT in SU users was significantly higher (7.96±5.17) compared to that of NSU (4.53±3.46; p=0.007). Salivary pH and BC were significantly and directly correlated (rs= 0.576). The former was significantly and directly correlated with SFR (rs= 0.404), but the latter was not. In contrast, BC inversely correlated with decay (rs= -0.385) and DMFT (rs= -0.399). Conclusions: Shammah use is associated with alterations in saliva quality (pH and BC). It is also associated with poor dental health either through a direct effect or mediation by altered salivary parameters.
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Affiliation(s)
- Mohammed S Al-Ak'hali
- Department of Preventive Dentistry, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia. E-mail.
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Abstract
Head and neck cancer (head and neck squamous cell carcinoma (HNSCC)) is a devastating disease. Patients require intensive treatment that is often disfiguring and debilitating. Those who survive are often left with poor speech articulation, difficulties in chewing and swallowing, and cosmetic disfigurement, as well as loss of taste. Furthermore, given that HNSCC survivors are frequently disabled and unable to return to work, the economic and societal costs associated with HNSCC are massive. HNSCC is one of many cancers that are strongly associated with tobacco use. The risk for HNSCC in smokers is approximately ten times higher than that of never smokers, and 70-80% of new HNSCC diagnoses are associated with tobacco and alcohol use. Tobacco products have been used for centuries; however, it is just within the last 60-70 years that we have developed an understanding of their damaging effects. This relatively recent understanding has created a pathway towards educational and regulatory efforts aimed at reducing tobacco use. Understanding the carcinogenic components of tobacco products and how they lead to HNSCC is critical to regulatory and harm reduction measures. To date, nitrosamines and other carcinogenic agents present in tobacco products have been associated with cancer development. The disruption of DNA structure through DNA adduct formation is felt to be a common mutagenic pathway of many carcinogens. Intense work pertaining to tobacco product constituents, tobacco use, and tobacco regulation has resulted in decreased use in some parts of the world. Still, much work remains as tobacco continues to impart significant harm and contribute to HNSCC development worldwide.
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Affiliation(s)
- Ashok R Jethwa
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, MMC 396, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Samir S Khariwala
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, MMC 396, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
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Consumption and direct costs of dental care for patients with head and neck cancer: A 16-year cohort study. PLoS One 2017; 12:e0182877. [PMID: 28832673 PMCID: PMC5568378 DOI: 10.1371/journal.pone.0182877] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/26/2017] [Indexed: 02/03/2023] Open
Abstract
Patients with head and neck (H&N) cancer are commonly treated with surgery and/or radiotherapy, which can increase the risk of oral infection, dental caries, and periodontal disease. The present study investigated dental care consumption and costs in patient with H&N cancer before and after the cancer diagnosis. Data from Swedish regional and national registers were used to follow up dental care utilization and dental procedure costs. The analysis included 2,754 patients who had been diagnosed with H&N cancer (exposed cohort) in Stockholm County, Sweden, during 2000–2012 and 13,036 matched persons without cancer (unexposed cohort). The exposed cohort was sub-grouped into irradiated and non-irradiated patients for analysis. The exposed cohort underwent a moderately higher number of dental procedures per year than the unexposed cohort in both the year of the cancer diagnosis and the year after cancer diagnosis; in addition, these numbers were higher in the irradiated than in the non-irradiated subgroup of the exposed cohort. Dental care consumption and costs in the exposed cohort declined over time but remained at a slightly higher level than in the unexposed cohort over the long term (more than two years). Examinations and preventive procedures accounted for most of the higher consumption in the short term (2 years) and at the longer term follow-up. Swedish national insurance subsidized costs for dental treatment, which were highest in the irradiated subgroup and lowest in the unexposed cohort. Direct costs to the patient, however, were similar among the groups. Swedish national health insurance protects patients with H&N cancer from high dental expenditures. Further studies on the cost-effectiveness of preventive dental care for patients are needed.
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Stepanov I, Gupta PC, Parascandola M, Yershova K, Jain V, Dhumal G, Hatsukami DK. Constituent Variations in Smokeless Tobacco Purchased in Mumbai, India. TOB REGUL SCI 2017; 3:305-314. [PMID: 34734108 PMCID: PMC8562702 DOI: 10.18001/trs.3.3.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Worldwide, smokeless tobacco products vary greatly in their formulations and chemical composition. Understanding of toxic and carcinogenic constituent variations in such products can provide valuable insights for the development of effective tobacco control policies. In this study, we applied a standardized protocol to collect and analyze smokeless products sold in Mumbai, India. METHODS Tobacco products were purchased at three markets in Mumbai, using standardized protocol for sample collection, labeling, and storage. Moisture content, pH, total and unprotonated nicotine, and five tobacco-specific N-nitrosamines (TSNA) were analyzed by validated methods. RESULTS We purchased 39 samples representing eight varieties of manufactured and vendor-made smokeless tobacco products. Total nicotine ranged from 5.3 to 57.8 mg/g dry weight. Unprotonated nicotine content varied from 0.13% to 99.8% of total nicotine. Total TSNA content ranged from 0.17 to 81.0 μg/g dry weight. When expressed per wet weight of product, unprotonated nicotine varied more than 300-fold and TSNA content varied more than 650-fold across the products. Substantial vendor-to-vendor variations were also observed. CONCLUSIONS Our findings emphasize the critical need for systematic smokeless tobacco surveillance in India, to improve understanding of exposures and cancer risks in users of these products.
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Affiliation(s)
- Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Prakash C. Gupta
- Healis-Sekhsaria Institute for Public Health, Mumbai, Maharashtra, India
| | - Mark Parascandola
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Katrina Yershova
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Vipin Jain
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gauri Dhumal
- Healis-Sekhsaria Institute for Public Health, Mumbai, Maharashtra, India
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Dhingra V, Verma J, Misra V, Srivastav S, Hasan F. Evaluation of Cyclin D1 expression in Head and Neck Squamous Cell Carcinoma. J Clin Diagn Res 2017; 11:EC01-EC04. [PMID: 28384866 DOI: 10.7860/jcdr/2017/21760.9329] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 09/06/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Squamous Cell Carcinoma (SCC) is an aggressive epithelial malignancy of the upper aero digestive tract and comprises 90% of all Head and Neck Squamous Cell Carcinoma (HNSCC). It is the sixth leading cancer worldwide with approximately 600,000 cases reported annually. It is one of the most common cancers in India. Tumour Lymph Node and Metastases (TNM) staging has been the most useful indicator to predict prognosis in HNSCC but recently various biomolecular markers have potentially offered new methods for early diagnosis and treatment alternatives for HNSCC patients; one amongst them being cyclin D1. AIM This study has been undertaken to evaluate expression of cyclin D1 in HNSCC cases and to find out its association with various pathological prognostic factors. MATERIALS AND METHODS A 48 formalin fixed paraffin embedded tumour sections, stained with Haematoxylin & Eosin were graded and staged. Immunohistochemistry for cyclin D1 was evaluated as Extent Score (ES), Intensity Score (IS) and Total Score (TS) was calculated. STATISTICAL ANALYSIS All the relevant data collected was transferred on to the excel sheet. Chi square test with and without Yate's correction was used to compare various parameters. The p-value ≤ 0.05 was taken as critical level of significance. RESULTS A significant association was seen between TS of Cyclin D1 expression with tumour stage and with lymph node metastasis but not with grade. CONCLUSION Higher Cyclin D1 expression is associated with higher tumour stage and lymph node metastasis. Therefore, there is value of analysing cyclin D1 amplification and expression, for prognostic evaluation. This may also be further used for targeted therapy in head and neck cancers.
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Affiliation(s)
- Vishal Dhingra
- Assistant Professor, Department of Pathology, M.L.N Medical College , Allahabad, Uttar Pradesh, India
| | - Jyoti Verma
- Student, Department of Pathology, M.L.N Medical College , Allahabad, Uttar Pradesh, India
| | - Vatsala Misra
- Consultant Oncosurgeon, Department of Pathology, M.L.N Medical College , Allahabad, Uttar Pradesh, India
| | - Sapan Srivastav
- Professor, Department of Pathology, M.L.N Medical College , Allahabad, Uttar Pradesh, India
| | - Faheema Hasan
- Student, Department of Pathology, M.L.N Medical College , Allahabad, Uttar Pradesh, India
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Wyss AB, Hashibe M, Lee YCA, Chuang SC, Muscat J, Chen C, Schwartz SM, Smith E, Zhang ZF, Morgenstern H, Wei Q, Li G, Kelsey KT, McClean M, Winn DM, Schantz S, Yu GP, Gillison ML, Zevallos JP, Boffetta P, Olshan AF. Smokeless Tobacco Use and the Risk of Head and Neck Cancer: Pooled Analysis of US Studies in the INHANCE Consortium. Am J Epidemiol 2016; 184:703-716. [PMID: 27744388 PMCID: PMC5141945 DOI: 10.1093/aje/kww075] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 02/25/2016] [Indexed: 01/14/2023] Open
Abstract
Previous studies on smokeless tobacco use and head and neck cancer (HNC) have found inconsistent and often imprecise estimates, with limited control for cigarette smoking. Using pooled data from 11 US case-control studies (1981-2006) of oral, pharyngeal, and laryngeal cancers (6,772 cases and 8,375 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, we applied hierarchical logistic regression to estimate odds ratios and 95% confidence intervals for ever use, frequency of use, and duration of use of snuff and chewing tobacco separately for never and ever cigarette smokers. Ever use (versus never use) of snuff was strongly associated with HNC among never cigarette smokers (odds ratio (OR) = 1.71, 95% confidence interval (CI): 1.08, 2.70), particularly for oral cavity cancers (OR = 3.01, 95% CI: 1.63, 5.55). Although ever (versus never) tobacco chewing was weakly associated with HNC among never cigarette smokers (OR = 1.20, 95% CI: 0.81, 1.77), analyses restricted to cancers of the oral cavity showed a stronger association (OR = 1.81, 95% CI: 1.04, 3.17). Few or no associations between each type of smokeless tobacco and HNC were observed among ever cigarette smokers, possibly reflecting residual confounding by smoking. Smokeless tobacco use appears to be associated with HNC, especially oral cancers, with snuff being more strongly associated than chewing tobacco.
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Affiliation(s)
- Annah B. Wyss
- Correspondence to Dr. Annah B. Wyss, Epidemiology Branch, National Institute of Environmental Health Sciences, P.O. Box 12233, MD A3-05, Research Triangle Park, NC 27599 (e-mail: )
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Pegoraro DR, Zanchet B, Guariente CDO, Rocha JDP, Batista JS. Analysis of the frequency and degree of temporomandibular disorder in patients with head and neck cancer undergoing radiotherapy. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/0103-5150.029.002.ao15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Head and neck cancer is responsible for an increasing incidence of primary malignant neoplasm cases worldwide. Radiotherapy is one of the treatments of choice for this type of cancer, but it can cause adverse effects, such as temporomandibular disorder. The objective of this study was to characterize the degree and frequency of temporomandibular disorder in patients with head and neck cancer undergoing radiotherapy. Method: This research was quantitative, descriptive and exploratory. The sample consisted of 22 patients that answered assessment questions and the Helkimo anamnestic questionnaire, modified by Fonseca (1992). The data were collected from May to October 2014, and statistically analyzed using the Chi-square test, with a significance level of p ≤ 0.05. Results: Of the 22 patients, 86.4 % were male, with a mean age of 58.86 ± 9.41 years. Temporomandibular disorder was present in 31.8% of the subjects, based on the assessment prior to radiotherapy, and in 59.1% in the post-treatment assessment. Among all questions, the most frequent was "Do you use only one side of the mouth to chew?" with 22.7% "yes" answers, both at the first assessment and at the post treatment. Conclusion: According to the results of this study, temporomandibular disorder is a disease that is present with a high prevalence in people diagnosed with head and neck cancer undergoing radiotherapy.
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Ahmed HG, Mustafa SA, Warille E. Human papilloma virus attributable head and neck cancer in the sudan assessed by p16INK4A immunostaining. Asian Pac J Cancer Prev 2016; 13:6083-6. [PMID: 23464408 DOI: 10.7314/apjcp.2012.13.12.6083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to screen for human papillomavirus (HPV) infections in head and neck squamous cell carcinomas (HNSCCs) using P16 immunostaining. MATERIALS AND METHODS A retrospective study was performed on 150 samples from patients diagnosed with HNSCCs. HPV status was determined using p16INK4A. RESULTS 31 of the 150 (20.7%) HNSCCs were HPV positive. CONCLUSIONS A large proportion of HNSCCs in Sudan are associated with HPV infection. The fact that the prevalence of HPV is high among Sudanese patients with head and neck cancers (HNC) has obvious implications for vaccine therapy.
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Song MA, Marian C, Brasky TM, Reisinger S, Djordjevic M, Shields PG. Chemical and toxicological characteristics of conventional and low-TSNA moist snuff tobacco products. Toxicol Lett 2016; 245:68-77. [PMID: 26802282 PMCID: PMC4910161 DOI: 10.1016/j.toxlet.2016.01.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/05/2016] [Accepted: 01/18/2016] [Indexed: 01/06/2023]
Abstract
Use of smokeless tobacco products (STPs) is associated with oral cavity cancer and other health risks. Comprehensive analysis for chemical composition and toxicity is needed to compare conventional and newer STPs with lower tobacco-specific nitrosamines (TSNAs) yields. Seven conventional and 12 low-TSNA moist snuff products purchased in the U.S., Sweden, and South Africa were analyzed for 18 chemical constituents (International Agency for Research on Cancer classified carcinogens), pH, nicotine, and free nicotine. Chemicals were compared in each product using Wilcoxon rank-sum test and principle component analysis (PCA). Conventional compared to low-TSNA moist snuff products had higher ammonia, benzo[a]pyrene, cadmium, nickel, nicotine, nitrate, and TSNAs and had lower arsenic in dry weight content and per mg nicotine. Lead and chromium were significantly higher in low-TSNA moist snuff products. PCA showed a clear difference for constituents between conventional and low-TSNA moist snuff products. Differences among products were reduced when considered on a per mg nicotine basis. As one way to contextualize differences in constituent levels, probabilistic lifetime cancer risk was estimated for chemicals included in The University of California's carcinogenic potency database (CPDB). Estimated probabilistic cancer risks were 3.77-fold or 3-fold higher in conventional compared to low-TSNA moist snuff products under dry weight or under per mg nicotine content, respectively. In vitro testing for the STPs indicated low level toxicity and no substantial differences. The comprehensive chemical characterization of both conventional and low-TSNA moist snuff products from this study provides a broader assessment of understanding differences in carcinogenic potential of the products. In addition, the high levels and probabilistic cancer risk estimates for certain chemical constituents of smokeless tobacco products will further inform regulatory decision makers and aid them in their efforts to reduce carcinogen exposure in smokeless tobacco products.
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Affiliation(s)
- Min-Ae Song
- Division of Epidemiology, The Ohio State University, The College of Public Health, Columbus, OH, USA; Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH, USA
| | - Catalin Marian
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH, USA; Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Theodore M Brasky
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH, USA
| | - Sarah Reisinger
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH, USA
| | - Mirjana Djordjevic
- Tobacco Control Research Branch, National Cancer Institute, Rockville, MD, USA
| | - Peter G Shields
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH, USA.
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Stepanov I, Gupta PC, Dhumal G, Yershova K, Toscano W, Hatsukami D, Parascandola M. High levels of tobacco-specific N-nitrosamines and nicotine in Chaini Khaini, a product marketed as snus. Tob Control 2015; 24:e271-4. [PMID: 25217658 PMCID: PMC4929854 DOI: 10.1136/tobaccocontrol-2014-051744] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 08/26/2014] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Recently, a tobacco product, Chaini Khaini, identified as snus appeared in India. The product marketing emphasises its discreet nature and explicitly claims safety by referring to the existing evidence on Swedish snus. We analysed tobacco-specific nitrosamines and nicotine in 12 samples of Chaini Khaini purchased in 2013 at open markets in India. METHODS Samples were purchased twice: in March 2013 from Mumbai and in November 2013 from Mumbai and Ahmedabad. Chemical constituents were measured by our routine validated methods. RESULTS Levels of carcinogenic nitrosamines NNN, NNK and NNAL averaged 22.9 (±4.9), 2.6 (±1.0) and 3.1 (±1.5) µg/g tobacco (wet weight), respectively. The levels of NAB, which is normally present in trace levels in tobacco products, ranged from 3.9 to 12.9 µg/g tobacco. Total nicotine levels in all samples averaged 10.0 mg/g tobacco and unprotonated nicotine accounted for an average 95.4% of the total nicotine content. CONCLUSIONS Chaini Khaini, which is labelled as snus and is marketed as a safe alternative to other tobacco products contains very high levels of carcinogenic nitrosamines and biologically available nicotine. Interventions are urgently needed to educate current and potential consumers of this product.
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Affiliation(s)
- Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Prakash C Gupta
- Healis-Sekhsaria Institute for Public Health, Mumbai, Maharashtra, India
| | - Gauri Dhumal
- Healis-Sekhsaria Institute for Public Health, Mumbai, Maharashtra, India
| | - Katrina Yershova
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - William Toscano
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Dorothy Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mark Parascandola
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, Maryland, USA
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Al-Tayar B, Tin-Oo MM, Sinor MZ, Alakhali MS. Prevalence and association of smokeless tobacco use with the development of periodontal pocket among adult males in Dawan Valley, Yemen: a cross-sectional study. Tob Induc Dis 2015; 13:35. [PMID: 26539068 PMCID: PMC4632360 DOI: 10.1186/s12971-015-0061-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/22/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The traditional type of smokeless tobacco used in the Arabian Peninsula, particularly common in Yemen, is called shammah. This study aims to determine the prevalence of shammah use and its association with the development of periodontal pockets. Other associated factors with the development of periodontal pocket were also determined. METHODS This cross-sectional study included 346 adult males aged 18 years old to 68 years old. Socio-demographic characteristics, oral hygiene practices, and shammah use history were surveyed by using a structured interview questionnaire. The clinical assessment for the presence or absence of periodontal pockets was assessed on the basis of community periodontal index. The chi-square test was used to assess significant differences in study groups in terms of the presence of periodontal pockets. Multivariable logistic regression was selected to assess potential associated factors with the development of periodontal pockets. RESULTS Among the 346 adult males, 248 (71.7 %), 30 (8.6 %), and 68 (19.7 %) males never used shammah, were former shammah users, and were current shammah users, respectively. The significant associated factors with the development of periodontal pocket were age group (30 years old and above) (Adjusted Odds Ratio (AOR) = 2.03, 95 % CI: 1.13, 3.65; P = 0.018), low family income category (AOR = 2.35, 95 % CI: 1.39, 3.99; P = 0.001), former shammah user (AOR = 2.66, 95 %: CI: 1.15, 6.15; P = 0.022), and current shammah user (AOR = 6.62, 95 %: CI: 3.59, 12.21; P = 0.001). CONCLUSIONS The results revealed that periodontal pockets were significantly associated with age group (30 years old and above), low family income category, former shammah use, and current shammah use. The findings of the current study highlighted the need to develop comprehensive shammah prevention programs and reduce periodontal disease and other shammah-associated diseases.
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Affiliation(s)
- Badr Al-Tayar
- />School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
| | - Mon Mon Tin-Oo
- />School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
| | - Mohd Zulkarnian Sinor
- />School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
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Siddiqi K, Shah S, Abbas SM, Vidyasagaran A, Jawad M, Dogar O, Sheikh A. Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries. BMC Med 2015; 13:194. [PMID: 26278072 PMCID: PMC4538761 DOI: 10.1186/s12916-015-0424-2] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/17/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Smokeless tobacco is consumed in most countries in the world. In view of its widespread use and increasing awareness of the associated risks, there is a need for a detailed assessment of its impact on health. We present the first global estimates of the burden of disease due to consumption of smokeless tobacco by adults. METHODS The burden attributable to smokeless tobacco use in adults was estimated as a proportion of the disability-adjusted life-years (DALYs) lost and deaths reported in the 2010 Global Burden of Disease study. We used the comparative risk assessment method, which evaluates changes in population health that result from modifying a population's exposure to a risk factor. Population exposure was extrapolated from country-specific prevalence of smokeless tobacco consumption, and changes in population health were estimated using disease-specific risk estimates (relative risks/odds ratios) associated with it. Country-specific prevalence estimates were obtained through systematically searching for all relevant studies. Disease-specific risks were estimated by conducting systematic reviews and meta-analyses based on epidemiological studies. RESULTS We found adult smokeless tobacco consumption figures for 115 countries and estimated burden of disease figures for 113 of these countries. Our estimates indicate that in 2010, smokeless tobacco use led to 1.7 million DALYs lost and 62,283 deaths due to cancers of mouth, pharynx and oesophagus and, based on data from the benchmark 52 country INTERHEART study, 4.7 million DALYs lost and 204,309 deaths from ischaemic heart disease. Over 85 % of this burden was in South-East Asia. CONCLUSIONS Smokeless tobacco results in considerable, potentially preventable, global morbidity and mortality from cancer; estimates in relation to ischaemic heart disease need to be interpreted with more caution, but nonetheless suggest that the likely burden of disease is also substantial. The World Health Organization needs to consider incorporating regulation of smokeless tobacco into its Framework Convention for Tobacco Control.
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Affiliation(s)
- Kamran Siddiqi
- Department of Health Sciences, Hull York Medical School, University of York, Room 105a, First floor, ARRC Building, Heslington, York, YO10 5DD, UK.
| | - Sarwat Shah
- Department of Health Sciences, Hull York Medical School, University of York, Room 105a, First floor, ARRC Building, Heslington, York, YO10 5DD, UK.
| | - Syed Muslim Abbas
- Fatima Memorial Hospital College of Medicine and Dentistry, Fatima Memorial System, Shadman, Lahore, 48000, Pakistan.
| | - Aishwarya Vidyasagaran
- Department of Health Sciences, Hull York Medical School, University of York, Room 105a, First floor, ARRC Building, Heslington, York, YO10 5DD, UK.
| | - Mohammed Jawad
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, Reynold's Building, Hammersmith, W6 8RP, UK.
| | - Omara Dogar
- Department of Health Sciences, Hull York Medical School, University of York, Room 105a, First floor, ARRC Building, Heslington, York, YO10 5DD, UK.
| | - Aziz Sheikh
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Medical School Doorway 3, Teviot Place, Edinburgh, EH8 9AG, UK.
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Abstract
This article discusses risk factors, incidence trends, and prognostic considerations for head and neck cancer (HNC). The primary causes of HNC are tobacco and alcohol use, and human papillomavirus (HPV). Tobacco-related HNC incidence rates are decreasing in countries where tobacco use has declined. HPV-HNC, which occurs primarily in the oropharynx and is associated with sexual behaviors, has been increasing over the past several decades, among white men in particular. The prognosis for HNC overall has improved slightly since the 1990s, and is influenced by site, stage, and HPV status. Prognosis for HPV-HNC is significantly better than for HPV-negative disease.
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Affiliation(s)
- Eleni M Rettig
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
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Popova L, Kostygina G, Sheon NM, Ling PM. A qualitative study of smokers' responses to messages discouraging dual tobacco product use. HEALTH EDUCATION RESEARCH 2014; 29:206-21. [PMID: 24441592 PMCID: PMC3959203 DOI: 10.1093/her/cyt150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 11/25/2013] [Indexed: 06/02/2023]
Abstract
Cigarette companies increasingly promote novel smokeless tobacco products to smokers, encouraging them to use smokeless tobacco in smoke-free environments. New messages may counteract this promotion. We developed 12 initial anti-smokeless message ideas and tested them in eight online focus groups with 75 US smokers. Those smokers who never tried smokeless tobacco were unaware of health risks of novel smokeless tobacco products, perceived scary messages as effective and acknowledged the addictive nature of nicotine. Smokers who had tried smokeless tobacco shared their personal (mainly negative) experiences with smokeless tobacco, were aware of health risks of novel smokeless tobacco products, but denied personal addiction, and misinterpreted or disregarded more threatening messages. Portraying women as smokeless tobacco users was perceived as unbelievable, and emphasizing the lack of appeal of novel smokeless tobacco products was perceived as encouraging continued smoking. Future ads should educate smokers about risks of novel smokeless tobacco products, but past users and never users may require different message strategies.
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Affiliation(s)
- Lucy Popova
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA, Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA and Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Ganna Kostygina
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA, Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA and Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Nicolas M. Sheon
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA, Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA and Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA, Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA and Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
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Adkison SE, Bansal-Travers M, Smith DM, O'Connor RJ, Hyland AJ. Impact of smokeless tobacco packaging on perceptions and beliefs among youth, young adults, and adults in the U.S: findings from an internet-based cross-sectional survey. Harm Reduct J 2014; 11:2. [PMID: 24433301 PMCID: PMC3942180 DOI: 10.1186/1477-7517-11-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 01/09/2014] [Indexed: 02/04/2023] Open
Abstract
Background Research demonstrates that tobacco packaging elements (including health warning labels, descriptive characteristics, and corporate branding) are associated with knowledge of health risks and product appeal with cigarettes. Yet, little research has assessed this with smokeless tobacco (SLT) packaging. This study evaluates the association between three SLT packaging elements with knowledge of health risks and perceptions of novelty and appeal. Additionally, we assess how effects of these messages may differ across age groups, including youth (14-17 years), young adults (18-25 years), and older adults (26-65 years). Methods 1000 participants were administered a web-based survey in 2010 and shown three sets of SLT packs in random order, varied by descriptor (flavor descriptor vs. none), warning label format (graphic vs. text), and corporate branding (branded vs. plain packaging). Participants rated the packs compared with “no difference” on appeal, novelty, and risk perceptions associated with product use. Chi-square tests were used to test for significant differences in pack selections. Multinomial regression was employed to evaluate the association between effects of packaging elements and participant age. Results More respondents selected the pack with the graphic warning label as the pack to make them consider the health risks associated with SLT use, attract their attention, and be least attractive to a smoker. The product with the text warning label was the product someone their age would want to be seen using and would appeal to peers. The SLT pack with the flavor descriptor was not associated with health risks associated with product use. The pack with corporate branding was selected as more appealing, to attract attention, and one they would want to be seen using; the plain pack was less attractive to smokers. Youth and young adults were more likely to indicate that pack elements affected their perceptions of appeal and risk associated with SLT products. Conclusion These results suggest that SLT pack characteristics have a measurable effect on perceptions of health risk and product appeal. Future research should assess these findings in the context of harm reduction. Specifically, research is needed to determine whether pack elements on SLT products can effectively convey risk and harm.
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Affiliation(s)
| | - Maansi Bansal-Travers
- Roswell Park Cancer Institute, Department of Health Behavior, Elm & Carlton Streets Buffalo, New York 14263, USA.
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Hossain MS, Kypri K, Rahman B, Milton AH. Smokeless tobacco consumption in the South Asian population of Sydney, Australia: prevalence, correlates and availability. Drug Alcohol Rev 2013; 33:86-92. [DOI: 10.1111/dar.12074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 09/10/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Mohammad Shakhawat Hossain
- School of Medicine and Public Health; Faculty of Health and Medicine; The University of Newcastle; Newcastle Australia
| | - Kypros Kypri
- School of Medicine and Public Health; Faculty of Health and Medicine; The University of Newcastle; Newcastle Australia
| | - Bayzidur Rahman
- School of Public Health and Community Medicine; University of New South Wales; Sydney Australia
| | - Abul Hasnat Milton
- School of Medicine and Public Health; Faculty of Health and Medicine; The University of Newcastle; Newcastle Australia
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