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Khalifeh M, Ginex P, Boffetta P. Reduction of head and neck cancer risk following smoking cessation: a systematic review and meta-analysis. BMJ Open 2024; 14:e074723. [PMID: 39122405 PMCID: PMC11331934 DOI: 10.1136/bmjopen-2023-074723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/28/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE Head and neck (HN) cancer comprises the neoplasms originating from the oral cavity, pharynx and larynx. We aimed at reviewing the available literature on the effect of smoking cessation on HN cancer risk. METHOD We conducted a systematic search in Medline, PubMed and Embase to June 2022. We abstracted or calculated relative risks (RR) and 95% CIs of HN cancer after cessation of tobacco smoking (both former smoking status and duration of quitting) and combined them using random effects meta-analyses. Papers included were case-control or cohort studies available in the English language. Studies investigating smoking cessation after cancer diagnosis, case reports, intervention studies or animal studies were excluded. Quality and susceptibility to bias of each included study were evaluated using the Newcastle-Ottawa Scale. Publication bias was assessed using funnel plot and Egger's test. RESULTS A total of 65 studies were included in the review, including 5 cohort and 60 case-control studies. The RR of HN cancer for former smokers compared with current smokers was 0.40 (95% CI 0.35 to 0.46). In an analysis by cancer site, the RR of oral cancer was 0.44 (95% CI 0.35 to 0.55), that of pharyngeal cancer 0.44 (95% CI 0.32 to 0.60) and that of laryngeal cancer 0.38 (95% CI 0.29 to 0.50). The dose-response meta-analysis was based on 37 studies. The RR per 10-year increase in smoking cessation was 0.47 (95% CI 0.43 to 0.52). CONCLUSIONS The risk of HN cancer declines within the first 5 years of quitting smoking. Quitting smoking is an essential element of HN cancer prevention. TRIAL REGISTRATION NUMBER The protocol has been deposited in the PROSPERO repository (CRD42022338262).
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Affiliation(s)
- Malak Khalifeh
- Stony Brook University Hospital, Stony Brook, New York, USA
| | - Pamela Ginex
- Stony Brook University, Stony Brook, New York, USA
| | - Paolo Boffetta
- Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Shoorgashti R, Moshiri A, Lesan S. Evaluation of Oral Mucosal Lesions in Iranian Smokers and Non-smokers. Niger J Clin Pract 2024; 27:467-474. [PMID: 38679769 DOI: 10.4103/njcp.njcp_702_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 03/01/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Tobacco smoking statistics are alarming and the oral mucosa is the first human part of the body that is exposed to the toxic substances of smoking. AIMS Considering the high prevalence rate of tobacco-associated problems in the oral cavity and few studies on the Iranian population regarding the effects of smoking on the oral cavity, this study aimed to evaluate the relationship between smoking and oral lesions in the Iranian population. MATERIALS AND METHODS Observational study. In this observational study, the oral cavities of 200 participants (smokers = 100 and non-smokers = 100) were examined by a trained dental student under the supervision of an oral and maxillofacial medicine expert, and the presence of coated tongue, leukoedema, leukoplakia, smoker's palate, smoker's melanosis, erythroplakia, frictional hyperkeratosis, acute pseudomembranous candidiasis, and erythematous candidiasis were recorded. Xerostomia was evaluated based on participants' self-reporting through a questionnaire. All data were analyzed using T-test, Chi-square test, odd ratio, 95% confidence interval, Fisher's exact test, and Spearman's rank correlation coefficient. RESULTS The results of this study showed smoking is significantly associated with an increased risk of coated tongue (OR: 1.80, 95% CI: 1.32-3.54, P = 0.005), smoker's melanosis (OR: 6.176, 95% CI: 3.28-11.62, P = 0.00002), and frictional hyperkeratosis (OR: 1.33, 95% CI: 0.68-2.60, P = 0.005). However, no significant association was observed between smoking and leukoedema (OR: 1, 95% CI: 0.51-1.94, P = 1). None of the participants presented smoker's palate, erythroplakia, and candidiasis. CONCLUSIONS This study's results showed that smokers exhibited a greater chance of developing oral lesions compared to non-smokers.
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Affiliation(s)
- R Shoorgashti
- Oral Medicine Department, Islamic Azad University of Medical Sciences, Tehran, Iran
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Zheng S, Xie S, Yu H, Duan X, He Y, Ho C, Wan Y, Hang T, Chen W, Lyu J, Deng L. Competing-risks analysis for evaluating the prognosis of patients with microinvasive cutaneous squamous cell carcinoma based on the SEER database. BMC Med Res Methodol 2023; 23:286. [PMID: 38062392 PMCID: PMC10701925 DOI: 10.1186/s12874-023-02109-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Utilizing the traditional Cox regression model to identify the factors affecting the risk of mortality due to microinvasive cutaneous squamous cell carcinoma (micSCC) may produce skewed results. Since cause-specific mortality can guide clinical decision-making, this study employed the Fine-Gray model based on the Surveillance, Epidemiology, and End Results (SEER) database to identify significant predictive variables for the risk of micSCC-related mortality. METHODS This study used the information of patients with micSCC who were listed in the SEER database during 2000-2015. Cox regression and Fine-Gray models were utilized for the multivariable analysis, and Gray's test and the cumulative incidence function were used for the univariable analyses. RESULTS There were 100 patients who died from other reasons and 38 who died from micSCC among the 1259 qualified patients with micSCC. Most were female, white, married, had localized metastasis, etc. According to the univariable Gray's test (P < 0.05), the cumulative incidence rate for events of interest was strongly associated with age, sex, marital status, American Joint Committee on Cancer staging, radiation status, summary stage, chemotherapy status, surgery status, and tumor size. Multivariable Cox regression analysis and multivariable competing-risks analysis indicated that age, tumor size, and income were independent risk variables for the prognosis of patients with micSCC. In both age and tumor size variables, the competing-risks model showed a slight decrease in the hazard ratio and a slight narrowing of the 95% confidence interval compared with the Cox regression model. However, this pattern is not evident in the income variable. CONCLUSIONS This study established a Fine-Gray model for identifying the independent risk factors that influence the risk of mortality among patients with micSCC. This study uncovers that, in the context of competing risks, age, tumor size, and income serve as independent risk factors influencing the risk of mortality due to micSCC among patients. Our findings have the potential to provide more accurate risk assessments for patient outcomes and contribute to the development of individualized treatment plans.
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Affiliation(s)
- Suzheng Zheng
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - Shuping Xie
- School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Hai Yu
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - Xi Duan
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yong He
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - Chichien Ho
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China
| | - Yang Wan
- Guangzhou Jnumeso Bio-Technology Co., Ltd, Guangzhou, China
| | - Tie Hang
- Chinese Academy of Inspection and Quarantine Greater Bay Area, Zhongshan, China
| | - Wenhui Chen
- Shanghai Aige Medical Beauty Clinic Co., Ltd. (Agge), Shanghai, China.
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China.
| | - Liehua Deng
- Department of Dermatology, The First Affiliated Hospital of Jinan University and Jinan University Institute of Dermatology, Guangzhou, China.
- Department of Dermatology, The Fifth Affiliated Hospital of Jinan University, Heyuan, China.
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Dalirsani Z, Delavarian Z, Pakfetrat A, Akbarzade Mahlabani F, Taherizadeh M, Ghazi A. Evaluation of Risk Factors in Patients with Head and Neck Cancer: A Case Control Study. ADDICTION & HEALTH 2023; 15:1-7. [PMID: 37560078 PMCID: PMC10408740 DOI: 10.34172/ahj.2023.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/08/2022] [Indexed: 08/11/2023]
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) is one of the most common types of cancer worldwide. Since there are many factors that influence the development of cancer, identifying risk factors plays an important role in cancer prevention. The aim of this study was therefore to identify the risk factors for HNSCC in Mashhad, Iran. METHODS In this case-control study, 76 patients with HNSCC were included as the case and 91 healthy people as the control group. A checklist of risk factors was completed for each participant and the two groups were compared for the presence of risk factors. Chi-square, t test, and Mann-Whitney tests were used to compare the data. Odds ratios (ORs) for several factors have also been determined. FINDINGS The educational level and body mass index (BMI) of the patients in the case group were significantly lower than in the control group (P<0.001). Moreover, there were significant differences between the two groups in terms of risk factors such as tobacco smoking, the number of cigarettes smoked per day, and its duration (P=0.001, P<0.001, P=0.05), as well as the duration of hookah smoking, opium consumed per day and use of alcohol (P=0.023, P<0.001, P=0.015). CONCLUSION There was a direct relationship between HNSCC and risk factors such as cigarette smoking, number of cigarettes smoked per day, duration of cigarette consumption and hookah, opium consumed per day, and alcohol use. However, extensive studies with larger sample sizes are needed to better assess the impact of these factors and generalize the results.
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Affiliation(s)
- Zohreh Dalirsani
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Professor, Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Delavarian
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Professor, Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atessa Pakfetrat
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Professor, Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mahboobeh Taherizadeh
- Master student in Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ala Ghazi
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Assistant Professor, Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Komlós G, Csurgay K, Horváth F, Pelyhe L, Németh Z. Periodontitis as a risk for oral cancer: a case-control study. BMC Oral Health 2021; 21:640. [PMID: 34911520 PMCID: PMC8672540 DOI: 10.1186/s12903-021-01998-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/24/2021] [Indexed: 01/22/2023] Open
Abstract
Background The aetiology of oral cancer is multifactorial, as various risk factors (genetics, socioeconomic and lifestyle factors) contribute to its development. Data in the literature suggest that people with periodontal disease have an increased risk of developing oral cancer, and the severity of periodontitis correlates with the appearance of oral squamous cell carcinoma. The aim of this study was to revise the non-genetic risk factors that may influence the development of OC, while focusing on the dental and periodontal status and OH.
Methods Two hundred patients (hundred diagnosed with oral cancer and hundred without oral cancer) were enrolled in our case–control study, to evaluate the association between oral cancer and the presence and severity of periodontitis, while examining several risk factors that might be responsible for oral cancer formation. A questionnaire customised for oral cancer patients was used to obtain the socioeconomic and lifestyle risk factors that may influence the development of oral squamous cell carcinoma. The dental and periodontal status along with the level of oral hygiene was recorded quantitatively. The chi-square and Mann–Whitney tests and logistic regression were used for the statistical analysis. Results By considering both the case and the control groups, a significant correlation was found between the incidence of oral cancer and some socioeconomic factors and lifestyle habits, such as the sex, age, education and alcohol consumption of an individual. The mean value of the Silness-Löe plaque index was significantly higher in the case population. The number of completely edentulous patients was higher among the oral cancer population. The incidence of oral cancer was 57.1% in patients with periodontal disease. In comparison, the incidence of oral squamous cell carcinoma was only 28.6% among the patients without periodontitis. Most of the oral cancer patients (72.1%) had stage 4 periodontitis. On the other hand, the vast majority of the control group (51.6%) had stage 2 periodontitis. Conclusion Periodontitis can be an individual risk factor for oral cancer development. Periodontally compromised individuals should be strictly monitored, especially those with severe periodontitis and coexisting lifestyle risk factors. Maintaining their periodontal health in at-risk patients can minimize cancer risks.
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Affiliation(s)
- György Komlós
- Department of Oro-Maxillofacial Surgery and Stomatology, Faculty of Dentistry, Semmelweis University, Mária str 52, 1085, Budapest, Hungary.
| | - Katalin Csurgay
- Department of Oro-Maxillofacial Surgery and Stomatology, Faculty of Dentistry, Semmelweis University, Mária str 52, 1085, Budapest, Hungary
| | - Ferenc Horváth
- Department of Public Health, Faculty of Medicine, Semmelweis University, Nagyvárad Sq. 4, 1089, Budapest, Hungary
| | | | - Zsolt Németh
- Department of Oro-Maxillofacial Surgery and Stomatology, Faculty of Dentistry, Semmelweis University, Mária str 52, 1085, Budapest, Hungary
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Al Deeb M, Alresayes S, A Mokeem S, Alhenaki AM, AlHelal A, Shafqat SS, Vohra F, Abduljabbar T. Clinical and immunological peri-implant parameters among cigarette and electronic smoking patients treated with photochemotherapy: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2020; 31:101800. [DOI: 10.1016/j.pdpdt.2020.101800] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/18/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
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Lins LS, Bezerra NV, Freire AR, Almeida LD, Lucena EH, Cavalcanti YW. Socio-demographic characteristics are related to the advanced clinical stage of oral cancer. Med Oral Patol Oral Cir Bucal 2019; 24:e759-e763. [PMID: 31655836 PMCID: PMC6901145 DOI: 10.4317/medoral.23105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/18/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Social determinants may be associated with the onset and progression of the clinical stage of oral cancer. AIM To evaluate the impact of socio-demographic characteristics on the prevalence of advanced clinical stage of oral cancer. MATERIAL AND METHODS Information about 51,116 cases of oral cancer, from all Brazilian states, between 2000 and 2012, was obtained from the Cancer Registry Information System. The clinical stage of oral cancer (dependent variable) was classified as initial (stages I and II) or advanced (stages III and IV). The relationship between the clinical stage of oral cancer and the following independent variables was analyzed: sex, age, schooling, marital status, family history of cancer, and origin of referral. Analyses on frequency distribution and multivariate binary logistic regression model were performed (α<0.05). RESULTS Compared to individuals with no schooling, those who attended elementary to high school (OR=2.461) and college education (OR = 3.050) had a higher prevalence of advanced cases of oral cancer. Individuals without a partner (OR = 14,209) demonstrated a higher prevalence compared to married individuals. Subjects aged 20-44 years (OR = 4.081) and 45-64 years (OR = 14.875) had a higher prevalence compared to those aged 15-19 years. The variables gender, family history of cancer and origin of referral integrated the binary model of logistic regression, but did not present statistical significance. CONCLUSIONS Socioeconomic factors may be related to the advanced clinical stage of oral cancer.
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Affiliation(s)
- L-S Lins
- Department of Clinical and Social Dentistry Center for Health Sciences Federal University of Paraiba - Campus I University City Joao Pessoa PB Brazil. CEP 58051-900
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BinShabaib M, ALHarthi SS, Akram Z, Khan J, Rahman I, Romanos GE, Javed F. Clinical periodontal status and gingival crevicular fluid cytokine profile among cigarette-smokers, electronic-cigarette users and never-smokers. Arch Oral Biol 2019; 102:212-217. [DOI: 10.1016/j.archoralbio.2019.05.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/28/2019] [Accepted: 05/02/2019] [Indexed: 02/09/2023]
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Rafieian N, Azimi S, Manifar S, Julideh H, ShirKhoda M. Is there any association between green tea consumption and the risk of head and neck squamous cell carcinoma: Finding from a case-control study. Arch Oral Biol 2018; 98:280-284. [PMID: 30583134 DOI: 10.1016/j.archoralbio.2018.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/02/2018] [Accepted: 12/06/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Green tea consumption has been shown to reduce the incidence of head and neck squamous cell carcinoma (HNSCC) in experimental animal models, however the results from human studies are inconclusive. The aim of this study was to evaluate the relationship between green tea consumption and the risk of HNSCC. DESIGN The study utilised a standardised questionnaire to investigate the relationship between green tea consumption and HNSCC experience. Data about amount of green tea consumption was recorded from 147 patients with HNSCC and 263 age and gender matched controls. The results were analyzed with SPSS statistical software Version 21 using Chi- square test, and Logistic Regression (with a 95% confidence interval). Significance levels were set at 95% and p-values less than 0.05 were considered significant. RESULTS Statistical analysis indicated significant differences between different groups of tea consumers in terms of HNSCC risk (P < 0.001). The risk of developing oral cancer those who consume <1 cup of green tea daily was (OR = 0.29 (0.16-0.52) and for the group of > = 1 cup green tea consumers was 0.38(0.17-0.86) of those who never consume green tea (Reference point) after adjustment for other risk factors. CONCLUSIONS The findings support that green tea consumption may reduce the risk of HNSCC. To confirm the efficacy of green tea intake in preventing the development of HNSCC in humans further investigation is needed.
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Affiliation(s)
- Nasrin Rafieian
- Oral Medicine Department, Dental School, Alborz University of Medical Sciences, Karaj, Iran; Dietary supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | - Somayyeh Azimi
- Honorary research Fellow, International Research Collaborative - Oral Health and Equity, Department of Human Sciences, School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, WA, Australia.
| | - Soheila Manifar
- Assistant professor, Department of Oral Medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tehran, Iran.
| | - Hamideh Julideh
- Dentist, Department of Oral Medicine, Faculty of Dentistry, Alborz University of Medical Sciences, Karaj, Iran.
| | - Mohammad ShirKhoda
- Assistant professor of Surgery Oncology, Department of Surgery, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Cohen A, Ianovski LE, Frenkiel S, Hier M, Zeitouni A, Kost K, Mlynarek A, Richardson K, Black M, MacDonald C, Chartier G, Rosberger Z, Henry M. Barriers to psychosocial oncology service utilization in patients newly diagnosed with head and neck cancer. Psychooncology 2018; 27:2786-2793. [DOI: 10.1002/pon.4889] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Alexandra Cohen
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
| | | | - Saul Frenkiel
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Michael Hier
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
| | - Anthony Zeitouni
- McGill University; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Karen Kost
- McGill University; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Alex Mlynarek
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Keith Richardson
- McGill University; Montreal Canada
- McGill University Health Centre; Montreal Canada
| | - Martin Black
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
| | | | | | - Zeev Rosberger
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
| | - Melissa Henry
- McGill University; Montreal Canada
- Jewish General Hospital; Montreal Canada
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