The incidence of squamous cell carcinoma of the tongue in young white women in the U.S. has risen steadily over the last three decades, according to a new study in the Journal of Clinical Oncology (March 7, 2011).
A team of researchers from the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center analyzed data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database and found that, between 1975 and 2007, the overall incidence of the disease for all ages, genders, and races was decreasing. However, the incidence of oral tongue squamous cell carcinoma rose 28% among individuals ages 18 to 44.
Specifically, the incidence increased 67% among white individuals ages 18 to 44 and 111% among white women ages 18 to 44.
"Lately we have been seeing more oral tongue cancer in young white women in our clinic," said Bhisham Chera, MD, lead author on the study and assistant professor in the department of radiation oncology. "So we looked at the literature, which reported an increase in oral tongue squamous cell carcinoma in young white individuals but couldn't find any information about gender-specific incidence rates, so we decided we should take a look at the SEER data."
Over the past decade, an association between the human papillomavirus (HPV) with squamous cell carcinoma of the tonsil and tongue has been observed. Patients with HPV-associated oral squamous cell carcinoma are typically male, white, nonsmokers, nondrinkers who are younger in age and have higher socioeconomic status.
The researchers at UNC have preliminarily tested the cancers of the oral tongue of their young white female patients and have not found them to be associated with the virus. Other institutions also have noted the absence of the virus in young women with oral tongue cancer. The UNC researchers have also anecdotally observed that these young white female patients are typically nonsmokers and nondrinkers.
"Our findings suggest that the epidemiology of this cancer in young white females may be unique and that the causative factors may be things other than tobacco and alcohol abuse," Dr. Chera noted. "Based on our observations and the published data, it appears that these cases may not be associated with the human papillomavirus. We are actively researching other causes of this cancer in this patient population."
Though the increasing rate of oral tongue cancer in young white women is alarming, oral tongue cancer is a rare cancer, relative to breast, lung, prostate, and colorectal cancers, he added.
"Primary care physicians and dentist should be aware of this increasing incidence and screen patients appropriately," he said.
