Risk factors for oral cancer in newly diagnosed patients aged 45 years and younger: a case-control study in Southern England

Background:  This case–control study aimed to identify the risk factors for oral cancer in patients aged 45 years and under. Methods:  Patients were recruited over a 3‐year period between 1999 and 2001 from 14 hospitals in the southeast of England, UK. Results:  Fifty‐three (80%) newly diagnosed pat...

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Bibliographic Details
Published in:Journal of oral pathology & medicine 2004-10, Vol.33 (9), p.525-532
Main Authors: Llewellyn, C. D., Johnson, N. W., Warnakulasuriya, K. A. A. S.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Alcohol Drinking - epidemiology
Biological and medical sciences
Carcinoma, Squamous Cell - epidemiology
Case-Control Studies
Confidence Intervals
Dentistry
Diet - statistics & numerical data
England - epidemiology
Female
Fruit
Humans
Logistic Models
Male
Marijuana Smoking - epidemiology
Medical sciences
Middle Aged
Mouth Neoplasms - epidemiology
Odds Ratio
oral cancer
Otorhinolaryngology. Stomatology
Risk Factors
Sex Factors
Smoking - epidemiology
Smoking Cessation - statistics & numerical data
Tumors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
Vegetables
young people
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Summary:Background:  This case–control study aimed to identify the risk factors for oral cancer in patients aged 45 years and under. Methods:  Patients were recruited over a 3‐year period between 1999 and 2001 from 14 hospitals in the southeast of England, UK. Results:  Fifty‐three (80%) newly diagnosed patients with squamous cell carcinoma (SCC) of the oral cavity participated. The mean age of cases at diagnosis was 38.5 years (SD = 7.0) and 53% were male. Patients were interviewed about main risk factors of tobacco, alcohol, cannabis and their consumption of fresh fruit and vegetables in the past. Ninety‐one matched control patients were also recruited. Odds ratios (ORs) and 95% confidence intervals (CI) were obtained from adjusted conditional logistic analyses. Significantly elevated ORs were evidenced amongst males who had started to smoke under the age of 16 years (OR = 14.3; 95% CI: 1.1–178.8). A significant reduction in risk was also shown for ex‐smokers (OR = 0.2; 95% CI: 0.5–0.8). Consumption of alcohol in excess of recommended amounts also produced an eightfold risk in males (OR = 8.1; 95% CI: 1.6–40.1) and over a fourfold risk of oral cancer from the consumption of excessive amounts of alcohol and having ever smoked (OR = 4.4; 95% CI: 1.1–17.7). Conclusion:  The study shows that the traditional behavioural risk factors are present in younger people diagnosed with oral cancer. The relatively short duration of exposure and the substantial number of cases without any known risk factors, particularly amongst females, however, suggest that factors other than tobacco and alcohol may also be implicated in the development of oral cancer in a proportion of these younger patients.
ISSN:0904-2512
1600-0714
DOI:10.1111/j.1600-0714.2004.00222.x