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Lopez-Olivo MA, James J, James J, Krause KJ, Roth M, Palos GR, Ma H, Rodriguez A, Gilmore K, Cinciripini P, Suarez-Almazor ME. A systematic review and meta-analysis of e-cigarette use among cancer survivors. J Cancer Surviv 2024; 18:1059-1074. [PMID: 36952212 DOI: 10.1007/s11764-023-01357-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/01/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE We conducted a systematic review and meta-analysis to determine the use of e-cigarettes among cancer survivors, factors associated with their use, and prevalence of e-cigarette use as a quit attempt. METHODS We searched five electronic databases until June 2022. Two authors independently selected studies, appraised their quality, and collected data. RESULTS Twenty-three publications from eight data sources (national surveys) met our eligibility criteria. The pooled rate of lifetime e-cigarette use among cancer survivors was 15% (95% CI 6-27%); current use was 3% (95% CI 0-8%). Among survivors who currently used traditional cigarettes, 63% (95% CI 57-69%) also used e-cigarettes. The reported rates of weighted lifetime e-cigarette use differed between age groups (18-44 years, up to 46.7%; 45-64, up to 27.2%; ≥65, up to 24.8%). Nine publications reported factors associated with lifetime e-cigarette use (i.e., active use of traditional cigarettes; heavy drinking; poor mental health; younger age; being male, non-Hispanic White, or single; having less than high school education or income ≤$25,000 USD; and living in the South regions of the US or urban areas). E-cigarettes were used as a quit resource by 75% of survivors reporting dual use of electronic and traditional cigarettes (95% CI 63%, 85%). CONCLUSION More than two-thirds of survivors currently using traditional cigarettes also use e-cigarettes. Higher use rates of e-cigarettes were reported among young cancer survivors compared to older survivors. Future studies are needed to assess the impact of e-cigarettes on long-term health and improve screening of smoking behaviors. IMPLICATIONS FOR CANCER SURVIVORS Our study provides an overview of the prevalence of e-cigarette use and sociodemographic risk factors associated with e-cigarette use among cancer survivors. The findings can assist providers in supporting attempts to quit among cancer survivors.
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Affiliation(s)
- Maria A Lopez-Olivo
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, USA.
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1444, Houston, TX, 77030, USA.
| | - Justin James
- City University of New York School of Medicine, New York, NY, USA
| | - Joel James
- City University of New York School of Medicine, New York, NY, USA
| | - Kate J Krause
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Michael Roth
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Guadalupe R Palos
- Office of Cancer Survivorship, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Hilary Ma
- Department of General Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Alma Rodriguez
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Lymphoma-Myeloma, Houston, USA
| | - Katherine Gilmore
- Office of Cancer Survivorship, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Paul Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Maria E Suarez-Almazor
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, USA
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
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Falk GE, Okut H, Lightner JS, Farrokhian N, LaCrete F, Chiu A, Shnayder Y, Bond J, Sykes KJ. Forecasting Rural and Urban Otolaryngologists, Radiation Oncologists, and Oropharyngeal Carcinoma. Laryngoscope 2024; 134:136-142. [PMID: 37395265 DOI: 10.1002/lary.30809] [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: 11/23/2022] [Revised: 03/04/2023] [Accepted: 05/24/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To forecast oropharyngeal carcinoma (OPC) incidence with otolaryngologist and radiation oncologist numbers per population by rural and urban counties through 2030. METHODS Incident OPC cases were abstracted from the Surveillance, Epidemiology, and End Results 19 database, and otolaryngologists and radiation oncologists from the Area Health Resources File by county from 2000 to 2018. Variables were analyzed by metropolitan counties with over 1,000,000 people (large metros), rural counties adjacent to a metro (rural adjacent), and rural counties not adjacent to a metro (rural not adjacent). Data were forecasted via an unobserved components model with regression slope comparisons. RESULTS Per 100,000 population, forecasted OPC incidence increased from 2000 to 2030 (large metro: 3.6 to 10.6 cases; rural adjacent: 4.2 to 11.9; rural not adjacent: 4.3 to 10.1). Otolaryngologists remained stable for large metros (2.9 to 2.9) but declined in rural adjacent (0.7 to 0.2) and rural not adjacent (0.8 to 0.7). Radiation oncologists increased from 1.0 to 1.3 in large metros, while rural adjacent remained similar (0.2 to 0.2) and rural not adjacent increased (0.2 to 0.6). Compared to large metros, regression slope comparisons indicated similar forecasted OPC incidence for rural not adjacent (p = 0.58), but greater for rural adjacent (p < 0.001, r = 0.96). Otolaryngologists declined for rural regions (p < 0.001 and p < 0.001, r = -0.56, and r = -0.58 for rural adjacent and not adjacent, respectively). Radiation oncologists declined in rural adjacent (p < 0.001, r = -0.61), while increasing at a lesser rate for rural not adjacent (p = 0.002, r = 0.96). CONCLUSIONS Rural OPC incidence disparities will grow while the relevant, rural health care workforce declines. LEVEL OF EVIDENCE NA Laryngoscope, 134:136-142, 2024.
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Affiliation(s)
- Grace E Falk
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Health System, Kansas City, Kansas, U.S.A
| | - Hayrettin Okut
- Office of Research and Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, Kansas, U.S.A
| | - Joseph S Lightner
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, Missouri, U.S.A
| | - Nathan Farrokhian
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Health System, Kansas City, Kansas, U.S.A
| | - Frantzlee LaCrete
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Health System, Kansas City, Kansas, U.S.A
| | - Alexander Chiu
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Health System, Kansas City, Kansas, U.S.A
| | - Yelizaveta Shnayder
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Health System, Kansas City, Kansas, U.S.A
| | - Justin Bond
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Health System, Kansas City, Kansas, U.S.A
| | - Kevin J Sykes
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Health System, Kansas City, Kansas, U.S.A
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Burruss CP, Sharrer C, Porterfield JZ, Kejner AE. Extranodal Extension Improves AJCC-8 Accuracy in HPV+ Oropharyngeal Cancer in a High-Risk Population. Laryngoscope 2023; 133:2621-2626. [PMID: 36655591 PMCID: PMC11253244 DOI: 10.1002/lary.30572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/27/2022] [Accepted: 01/01/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The American Joint Committee on Cancer's 8th edition (AJCC-8) separates oropharyngeal squamous cell carcinomas (OPSCCs) into human papillomavirus-positive (HPV+) tumors and HPV-negative tumors. Although AJCC-8 improves prognostic prediction for survival for the majority of HPV+ OPSCC, outliers are still encountered. The goal of this manuscript is to validate the AJCC-8 as a better metric of survivability than the AJCC-7 in an historically under-served rural population with confounding variables, such as tobacco use, alcohol consumption, and poor health care access and to analyze the role of extranodal extension (ENE) in this population. DESIGN Retrospective cohort study. RESULTS Compared to AJCC-7, AJCC-8 had a higher odds ratio (OR) for predicting mortality of stage IV HPV+ OPSCCs versus stages I-III. On multivariate analysis, HPV+ OPSCCs with ENE had a higher OR of mortality compared to ENE- OPSCCs. In addition, HPV+ OPSCC patients with a Charlson Comorbidity Index (CCI) > 3 had a higher OR of mortality compared to those with a CCI ≤ 3. Patients with Medicaid/self-pay status had a higher OR of mortality compared to those with private insurance/Medicare. Finally, patients from rural populations had a higher OR of presenting with stage IV disease, a CCI > 3, and Medicaid/self-pay status. CONCLUSIONS Despite not being a discrete part of the AJCC-8 staging rubric, ENE was found to have a significant impact on mortality among this population, whereas tobacco use had no effect. Rural patients were more likely to present with stage IV disease, CCI > 3, and Medicaid/self-pay status. Stage IV disease was also associated with a higher OR of mortality. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2621-2626, 2023.
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Affiliation(s)
| | | | - J. Zachary Porterfield
- University of Kentucky, Department of Otolaryngology-Head and Neck Surgery, Lexington, Kentucky, USA
- University of KwaZulu-Natal, Department of Otorhinolaryngology, Durban, South Africa
| | - Alexandra Eva Kejner
- Medical University of South Carolina, Department of Otolaryngology, Charleston, South Carolina, USA
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Shaikh K, Iqbal Y, Abdel-Maksoud MA, Murad A, Badar N, Alarjani KM, Siddiqui K, Chandio K, Almanaa TN, Jamil M, Ali M, Jabeen N, Hussein AM. Characterization of ferroptosis driver gene signature in head and neck squamous cell carcinoma (HNSC). Am J Transl Res 2023; 15:4829-4850. [PMID: 37560204 PMCID: PMC10408515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/29/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSC), a prevalent malignant tumor with a low survival rate, is often accompanied by ferroptosis, which is a recently-described type ofprogrammed cell death. Investigating the significance of ferroptosis driver genes in HNSC, this study aimed to assess their diagnostic and prognostic values, as well as their impact on treatment and tumor immune function. The results of this investigation provide novel insight into using ferroptosis-related genes as molecular biomarkers as well as precise chemotherapeutic targets for the therapy of HNSC. METHODOLOGY A detailed in silico and in vitro experiment-based methodology was adopted to achieve the goals. RESULTS A total of 233 ferroptosis driver genes were downloaded from the FerrDB database. After comprehensively analyzing these 233 ferroptosis driver genes by various TCGA databases, RNA-sequencing (RNA-seq), and Reverse Transcription Quantitative Real-Time Polymerase Chain Reaction (RT-qPCR) techniques, TP53 (tumor protein 53), PTEN (Phosphatase and TENsin homolog deleted on chromosome 10), KRAS (Ki-ras2 Kirsten rat sarcoma viral oncogene homolog), and HRAS (Harvey Rat sarcoma virus) were identified as differentially expressed hub genes. Interestingly, these hub genes were found to have significant (P < 0.05) variations in their mRNA and protein expressions and effects on overall survival of the HNSC patients. Moreover, targeted bisulfite-sequencing (bisulfite-seq) analysis revealed that promoter hypomethylation pattern was associated with up-regulation of hub genes (TP53, PTEN, KRAS, and HRAS). In addition to this, hub genes were involved in diverse oncogenic pathways. CONCLUSION Since HNSC pathogenesis is a complex process, using ferroptosis driver hub genes (TP53, PTEN, KRAS, and HRAS) as a diagnostic and prognostic tool, and therapeutically targeting those genes through appropriate drugs could bring a milestone change in the drug discovery and management and survival in HNSC.
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Affiliation(s)
- Khalida Shaikh
- Liaquat University of Medical and Health SciencesJamshoro, Pakistan
| | - Yusra Iqbal
- Continental Medical College LahoreLahore 54660, Pakistan
| | - Mostafa A Abdel-Maksoud
- Botany and Microbiology Department, College of Science, King Saud UniversityRiyadh 11451, Saudi Arabia
| | - Amina Murad
- Department of Bioscience, Comsats UniversityIslamabad, Pakistan
| | - Nadia Badar
- Department of Medical Oncology Allied HospitalFaisalabad, Pakistan
| | - Khaloud Mohammed Alarjani
- Botany and Microbiology Department, College of Science, King Saud UniversityRiyadh 11451, Saudi Arabia
| | - Komal Siddiqui
- Institute of Biotechnology and Genetic Engineering University of SindhJamshoro, Pakistan
| | | | | | - Muhammad Jamil
- PARC Arid Zone Research CentreDera Ismail Khan 29050, Pakistan
| | - Mubarik Ali
- Animal Science Institute, National Agricultural Research CenterIslamabad 54000, Pakistan
| | - Norina Jabeen
- Department of Rural Sociology, University of AgricultureFaisalabad 38000, Pakistan
| | - Ahmed M Hussein
- Department of Pharmaceutical Sciences, Division of Pharmacology and Toxicology, University of Vienna1090 Vienna, Austria
- Programme for Proteomics, Paracelsus Medical UniversitySalzburg, Austria
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Barsouk A, Aluru JS, Rawla P, Saginala K, Barsouk A. Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma. Med Sci (Basel) 2023; 11:42. [PMID: 37367741 DOI: 10.3390/medsci11020042] [Citation(s) in RCA: 55] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a group of malignancies, involving the oral cavity, pharynx, hypopharynx, larynx, nasal cavity, and salivary glands, that together compose the seventh most common cancer diagnosis worldwide. With 890,000 new cases and 450,000 deaths annually per GLOBOCAN estimates, HNSCC accounts for roughly 4.5% of cancer diagnoses and deaths. In the developing world, the incidence of HNSCC is growing with increasing consumption of tobacco (smoked or chewed), alcohol, and areca nut (betel quid). Alcohol and tobacco have a synergistic effect, with the heavy consumption of both increasing HNSCC risk 40-fold. In developed nations, HPV-related HNSCC surpasses tobacco- and alcohol-related disease. HPV-related HNSCC more commonly affects the oropharynx, hypopharynx, and larynx than the oral cavity, and is associated with a significantly longer median survival (130 months vs. 20 months). Discrepancies in etiology as well as disparities in lifestyle choices and access to healthcare may account for the greater incidence and poorer survival of HNSCC among minority and lower-socioeconomic-status communities in developed nations. Pharmacotherapy and counseling together have been shown to be effective in promoting smoking and alcohol cessation. Education on cancer risk and community engagement have reduced areca nut consumption in Asia as well as in diaspora communities. HPV vaccination, starting at age 11-12 for both sexes, has been shown to reduce the prevalence of high-risk HPV serologies and prevent pre-cancerous lesions of the cervix, vagina, and vulva. As of 2020, 58.6% of eligible adolescents in the US have received the full two-vaccine series. Increased adoption of vaccination, education on safe sex practices, and routine visual oral screening for high-risk patients would curb growing HNSCC incidence in developed nations.
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Affiliation(s)
- Adam Barsouk
- Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | | | - Kalyan Saginala
- Plains Regional Medical Group Internal Medicine, Clovis, NM 88101, USA
| | - Alexander Barsouk
- Hematologist-Oncologist, Allegheny Health Network, Pittsburgh, PA 15212, USA
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Urban MJ, Shimomura A, Shah S, Losenegger T, Westrick J, Jagasia AA. Rural Otolaryngology Care Disparities: A Scoping Review. Otolaryngol Head Neck Surg 2022; 166:1219-1227. [PMID: 35015580 DOI: 10.1177/01945998211068822] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To broadly synthesize the literature regarding rural health disparities in otolaryngology, categorize findings, and identify research gaps to stimulate future work. STUDY DESIGN Scoping review. DATA SOURCES A comprehensive literature search was performed in the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar, and CINAHL. REVIEW METHODS The methods were developed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Peer-reviewed, English-language, US-based studies examining a rural disparity in otolaryngology-related disease incidence, prevalence, diagnosis, treatment, or outcome were included. Descriptive studies, commentaries, reviews, and letters to the editor were excluded. Studies published prior to 1980 were excluded. RESULTS The literature search resulted in 1536 unique abstracts and yielded 79 studies that met final criteria for inclusion. Seventy-five percent were published after 2010. The distribution of literature was as follows: otology (34.2%), head and neck cancer (20.3%), endocrine surgery (13.9%), rhinology and allergy (8.9%), trauma (5.1%), laryngology (3.8%), other pediatrics (2.5%), and adult sleep (1.3%). Studies on otolaryngology health care systems also accounted for 10.1%. The most common topics studied were practice patterns (41%) and epidemiology (27%), while the Southeast (47%) was the most common US region represented, and database study (42%) was the most common study design. CONCLUSION Overall, there was low-quality evidence with large gaps in the literature in all subspecialties, most notably facial plastic surgery, laryngology, adult sleep, and pediatrics. Importantly, there were few studies on intervention and zero studies on resident exposure to rural populations, which will be critical to making rural otolaryngology care more equitable in the future.
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Affiliation(s)
- Matthew J Urban
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Aoi Shimomura
- Loyola University of Chicago, Stritch School of Medicine, Maywood, Illinois, USA
| | - Swapnil Shah
- Creighton University School of Medicine, Omaha, Nebraska, USA
| | - Tasher Losenegger
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Ashok A Jagasia
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
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Johnson M, Porterfield JZ, Kejner AE. Assessing the Applicability of the TALK Score: A Modification for Concurrent Tobacco Use During Treatment. Otolaryngol Head Neck Surg 2021; 166:282-288. [PMID: 34126807 DOI: 10.1177/01945998211020310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The previously described TALK score (T-stage, Albumin, Liquor, Karnofsky Performance Status) has been proposed as a method to predict laryngectomy-free survival (LFS) in patients undergoing definitive chemoradiation (CRT). This study assesses its use as well as a modification to include continued tobacco use. STUDY DESIGN Retrospective chart review. SETTING Academic institution from 2004 to 2020. METHODS Patients diagnosed with larynx or hypopharynx cancer undergoing CRT were reviewed. Clinically relevant variables were collected (TALK), which were dichotomized per previously set cutoffs. Concurrent tobacco use was evaluated and also dichotomized as 0 or 1. Multivariate analysis was conducted to determine which factors were most predictive of the key outcomes of survival and LFS. RESULTS A total of 2514 patient charts were evaluated. Patients treated for larynx cancer with primary CRT with complete data were included, ultimately totaling 300. Of these, 78 patients required salvage total laryngectomy (TL). Multivariate analysis demonstrated that LFS was best predicted by tobacco use during treatment (odds ratio [OR] 0.3465, 95% confidence interval [CI] 0.1862-0.6300) and Karnofsky Performance Status (OR 0.1646, 95% CI 0.0673-0.3662). Tobacco use during treatment was also strongly predictive of survival. Excluding T4 tumors, the utilization of tobacco in place of T-stage improved the accuracy of the predictive model in this cohort. CONCLUSION Given that a T-stage of 4 is typically treated with total laryngectomy, modification of the TALK score to include tobacco use during treatment (tALK) for patients with T < 4 can be used to improve prediction of 3-year LFS and overall survival.
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Affiliation(s)
- Mason Johnson
- University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - James Zachary Porterfield
- University of Kentucky Department of Otolaryngology-Head and Neck Surgery, Lexington, Kentucky, USA.,University of KwaZulu-Natal, Department of Otorhinolaryngology, Nelson Mandela School of Medicine, Durban, South Africa
| | - Alexandra Eva Kejner
- University of Kentucky Department of Otolaryngology-Head and Neck Surgery, Lexington, Kentucky, USA
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