Background: Head and neck cancers (HNCs) continue to remain a significant public health burden worldwide, causing significant mortality and morbidity despite significant clinical advances enabling their early diagnosis and treatment. Methods: We used data from the GLOBOCAN 2012, Cancer Incidence in Five Continents, World Health Organization Mortality Database and Surveillance, Epidemiology, and End Results programmes to describe the current epidemiology of HNCs. Results: Estimated age-standardised incidence/mortality rates for cancers of the lip and oral cavity among males and females (7.0/2.3 and 2.6/0.6 per 100,000 per annum) in more developed regions are higher compared to those in less developed regions (5.0/2.8 and 2.5/1.4 per 100,000 per annum). Similarly, the estimated rates for cancers of the tonsils and pharynx among males (7.5/2.5 per 100,000 per annum) and females (2.7/0.5 per 100,000 per annum) are reported to be the highest in Western Europe, whereas these rates for cancer of the larynx among males (7.9/4.0 per 100,000 per annum) and females (0.9/0.5 per 100,000 per annum) are reported to be the highest in the Caribbean. Cancer of the nasopharynx represents a significant HNC burden in the Asia-Pacific region and Northern Africa. Conclusion: The current and future estimated burden of HNCs is shifting to less developed regions which may be ill equipped to deal with this increasing burden. This needs urgent attention of policy makers through effective cancer control policy implementation with population-based interventions.

Global Epidemiology of Head and Neck Cancers: A Continuing Challenge.

Coeliac disease

Hypoxia, as characterized by the low local oxygen, confers on cancer cells resistance to oxygen-consuming photodynamic therapy (PDT). The limited success reached by current approaches harnessing reoxygenation to enhance PDT outcome promotes the reconsideration of the design of the therapeutic approach. In this study, a multistage delivery system capable of reversing hypoxia is demonstrated. Unlike previous strategies that only expect to affect the peripheral tumor tissue, the size-shrinkable system allows those deeply located hypoxia regions to be treated. Specifically, therapeutics, including atovaquone and indocyanine green derivatives that are respectively responsible for oxidative phosphorylation blockage and PDT, are encapsulated in a gelatin nanoparticle, whose structure would rupture to promote deep penetration when facing matrix metallopeptidase 2 enzyme overexpression in tumor tissue. The antihypoxic performance of the platform has been evaluated using a variety of analyses including flow-cytometry assay, immunofluorescence, and micro-positron-emission tomography imaging. Tumor regression in animal models confirms the feasibility and effectiveness of conquering the PDT-resistance through abrogating the oxygen consumption. It is hopeful that such a strategy could shed light on the development of next-generation PDT-adjuvant treatment.

Overcoming Hypoxia by Multistage Nanoparticle Delivery System to Inhibit Mitochondrial Respiration for Photodynamic Therapy

Oral cancer is the 11th most common cancer in the world, accounting for an estimated 300,000 new cases and 145,000 deaths in 2012 and 702,000 prevalent cases over a period of five years (old and new cases) (tables 5.1 and 5.2) (Bray and others 2013; Ferlay and others 2013). For this chapter, oral cancers include cancers of the mucosal lip, tongue, gum, floor of the mouth, palate, and mouth, corresponding to the International Classification of Diseases, 10th revision [ICD-10], codes C00, C02, C03, C04, C05, and C06, respectively. Two-thirds of the global incidence of oral cancer occurs in low- and middle- income countries (LMICs); half of those cases are in South Asia. India alone accounts for one-fifth of all oral cancer cases and one-fourth of all oral cancer deaths (Ferlay and others 2013).
Tobacco use, in any form, and excessive alcohol use are the major risk factors for oral cancer. With dietary deficiencies, these factors cause more than 90 percent of oral cancers. Preventing tobacco and alcohol use and increasing the consumption of fruits and vegetables can potentially prevent the vast majority of oral cancers (Sankaranarayanan and others 2013). When primary prevention fails, early detection through screening and relatively inexpensive treatment can avert most deaths. However, oral cancer continues to be a major cancer in India, East Asia, Eastern Europe, and parts of South America (Forman and others 2013), where organized prevention and early detection efforts are lacking. This chapter discusses the epidemiology, prevention, early detection, and treatment of oral cancers, as well as the cost-effectiveness of interventions.

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Oral Cancer: Prevention, Early Detection, and Treatment

Despite recent advances in therapy and treatment for oral cancer, survival rates are still low It is generally accepted that oral cancer may arise from potentially premalignant disorders Oral erythroplakia has been identified as the one with the highest malignant transformation rates The aim of this review was to provide detailed information on oral cancer and oral erythroplakia Few data are available on oral erythroplakia and there is an urgent need for randomized controlled trials Early detection and diagnosis is still the key to survival rates Dentists and physicians may play an important role in the detection of premalignant lesions and therefore improve patients' outcome

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1834-7819.2011.01337.x

Oral cancer and oral erythroplakia: an update and implication for clinicians

J Oral Pathol Med (2010) 39: 513–517

Background:  Oral cancer represents 2%–5% of all cancers, being one of the 10 most frequent ones. Apart from oral cancer risk factors already described in literature, such as tobacco and alcohol consumption, others emerging risk factors have been proposed, such as chronic irritation from dental factors. The aim of this work was to assess the influence of chronic trauma of the oral mucosa (CTOM) in patients with oral potentially malignant disorders (OPMD) and cancer.

Methods:  A retrospective study of 406 patients (both sexes; aged between 18 and 80 years; with OPMD and cancer) who attended the Department of Clinical Stomatology A of the National University of Cordoba was performed by non-probabilistic sampling. The association of variables and outcome variable diagnosis, with levels control, OPMD, oral cancer, was evaluated by multinomial regression model.

Results:  Population under study was represented by 72% of control patients, 16% patients with OPMD and 11% of patients with oral cancer. It was observed a significant association between diagnosis and CTOM (P = 0.000), after adjustment of confounding factors (smoking and drinking habits, sex, cancer inheritance and denture use).

Conclusions:  Our results suggest that CTOM is, together with other factors, an important risk factor in patients with oral cancer diagnosis, but not for patients with OPMD.

Relationship between chronic trauma of the oral mucosa, oral potentially malignant disorders and oral cancer

Risk genes in head and neck cancer: A systematic review and meta-analysis of last 5 years

Furcation Groove of Maxillary First Premolar, Thickness, and Dentin Structures

BACKGROUND Most of the studies dealing with Chronic Mechanical Irritation (CMI) and Oral Cancer (OC) only considered prosthetic and dental variables separately, and CMI functional factors are not registered. Thus, the aim of this study was to assess OC risk in individuals with dental, prosthetic and functional CMI. Also, we examined CMI presence in relation to tumor size. MATERIAL AND METHODS A case-control study was carried out from 2009 to 2013. Study group were squamous cell carcinoma cases; control group was patients seeking dental treatment in the same institution. RESULTS 153 patients were studied (Study group n=53, Control group n=100). CMI reproducibility displayed a correlation coefficient of 1 (p<0.0001). Bivariate analysis showed statistically significant associations for all variables (age, gender, tobacco and alcohol consumption and CMI). Multivariate analysis exhibited statistical significance for age, alcohol, and CMI, but not for gender or tobacco. Relationship of CMI with tumor size showed no statistically significant differences. CONCLUSIONS CMI could be regarded as a risk factor for oral cancer. In individuals with other OC risk factors, proper treatment of the mechanical injuring factors (dental, prosthetic and functional) could be an important measure to reduce the risk of oral cancer.

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Oral cancer associated with chronic mechanical irritation of the oral mucosa.

Objective. Oral mucosa could host many lesions originated by chronic mechanical irritation (CMI) from teeth or dentures, and it has been proposed as risk factor for oral cancer. Nevertheless, the features of CMI factors in oral cancer and other lesions are not assessed. The aim of this study is to describe CMI features regarding type (dental, prosthetic, and/or functional), localization, and time span. Materials and Methods. Three groups were studied in this cross-sectional study: Oral Cancer (OC); Chronic Traumatic Ulcer (CTU); and Benign Irritative Mechanical Lesions (BIML). All sources of mechanical irritation were included: dental, prosthetic, and functional. Results. 285 patients (176 females, 109 males) were studied: OC = 38, CTU = 44, and BIML = 203. The most frequent CMI factor was dental, followed by functional and prosthetic in all groups; 76.5% (n = 218) presented functional factors. Buccal mucosa (45%) and tongue (42%) were the most affected sites. Time of action of CMI displayed statistically significant differences between BIML, CTU, and OC groups, with a mean of 21, 33, and 49 months, respectively. Conclusions. CMI should be properly recorded with as much detail as alcohol and tobacco consumption. CMI associated lesions are produced by dental or prosthetic factors, usually in relation to functional factors, involving mainly tongue and buccal mucosa.

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Mabel Brunotto

Papers

Relationship between chronic trauma of the oral mucosa, oral potentially malignant disorders and oral cancer

Risk genes in head and neck cancer: A systematic review and meta-analysis of last 5 years

Furcation Groove of Maxillary First Premolar, Thickness, and Dentin Structures

Oral cancer associated with chronic mechanical irritation of the oral mucosa.

Characterization of Chronic Mechanical Irritation in Oral Cancer