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      A Meta-analysis of Oral Squamous Cell Carcinoma in Young Adults with a Comparison to the Older Group Patients (2014–2019)

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          Abstract

          Background:

          The oral squamous cell carcinoma (OSCC) often affects elderly aged adults, who had long-term tobacco exposure. In the recent past decade, there is an increasing incidence of OSCC in younger individuals, who had less tobacco association.

          Aim:

          The aim of this study is to examine the risk factors and to assess and compare the clinicopathological features and prognosis of OSCC in young patients with the older group patients.

          Materials and Methods:

          We included studies that addressed the OSCC involving young patients during the period between 2014 and 2019. Initially, we found 679 articles; after refined evaluation, 92 works had their titles matching to the present work. After extraction of case reports, reviews, and studies with un-matched objectives or inadequate data, we have chosen only 24 presentations matching to the abstract. The statistical analysis performed by Chi-square tests using SPSS 20.0 version for windows.

          Results:

          Of the total OSCC, 10% of patients belonged to the younger age group, and 90% were the older aged group. Both the groups showed male gender predominance and tongue as the predominant site of involvement. The younger patients tend to have significantly reduced tobacco exposure. The highly reported tumors were advanced staged and moderately differentiated tumors in both groups. There was a statistically evident high recurrence reported in the younger group. The overall survival seems to be similar for both groups.

          Conclusion:

          The identification of the potential risk factors, along with unique molecular mechanisms, and biological behavior of the disease is mandatory to control the incidence of OSCC in young adults.

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          Most cited references28

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            Analysis of the outcome of young age tongue squamous cell carcinoma

            Background The incidence of tongue squamous cell carcinoma (TSCC) in young patients has recently increased, and these TSCCs are believed to be etiologically distinct from those in older patients, who have longer exposure to risk factors such as tobacco and alcohol. The prognosis of TSCCs in young patients remains controversial. Methods We retrospectively reviewed the records of 117 patients (2001–2011) who were diagnosed with squamous cell carcinoma of the oral tongue. Patients were divided into two age groups, older (ages over 40) and younger (ages 40 and younger). Data were compared between the two groups, and survival rates were analyzed. Results The results show that there are significant differences in overall, disease-free, and distant metastasis-free survival rates between the two groups. Five-year overall survival rates were 70% in older patients and 42% in young patients (p = 0.033). Five-year disease-free survival rates were 73% in older patients and 40% in young patients (p = 0.011), and 5-year distant metastasis-free survival rates were 97% in older patients and 62% in young patients (p = 0.033). Multivariate analysis revealed that histologic grade was the only independent risk factor for overall survival in both groups of patients (p = 0.002, HR = 2.287). The analysis also demonstrated that age was the critical risk factor for distant metastasis (p = 0.046, HR = 9.687). Conclusion In this study, young (ages 40 and younger) patients with squamous cell carcinoma of the oral tongue had a higher rate of distant metastasis and a worse prognosis. Accordingly, we propose the necessity of an extensive therapeutic regimen that should be used in all young patients with TSCC.
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              Clinicopathological analysis of oral squamous cell carcinoma among the younger age group in coastal Karnataka, India: A retrospective study

              Aims: Oral squamous cell carcinoma (OSCC) primarily occurs in older age group. However, in the recent years, incidence of oral cancer in young people has been on rise worldwide. Towards this end, we sought to analyze the clinical and histopathological characteristics of OSCC in patients less than 45 years of age. Materials and Methods: The clinical and histological features of patients diagnosed with squamous cell carcinoma of the oral cavity at two hospitals in the coastal Karnataka region of South India between 1996-2012 were reviewed. The tabulation and descriptive statistics of the study were carried out. Results: A total of 420 patients were treated for OSCC in the 17-year period (1996-2012), of which 86 (20.5 %) patients were under 45 years of age. The most common site of involvement among the young was tongue (29.07%) and buccal mucosa (27.9%) respectively. A total of 47 (54.65%) patients were either habitual chewers, smokers, or alcoholics. Pathological grading of cases classified tumors into well differentiated (34.88%), moderately differentiated (46.51%) and poorly differentiated (4.65%). Conclusions: The data from this study reveals that a significant proportion of the OSCC cases are observed in patients of 45 years or younger. Additionally, our study also indicated an increase in the usage of tobacco and pan chewing in young adults in comparison to older individuals in the two hospitals of South India. The data obtained from this analysis emphasizes the need for screening programs that are tailor-made for individuals at high risk of developing oral cancer and warrants tobacco awareness programs in the community.
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                Author and article information

                Journal
                Contemp Clin Dent
                Contemp Clin Dent
                CCD
                Contemporary Clinical Dentistry
                Wolters Kluwer - Medknow (India )
                0976-237X
                0976-2361
                Jul-Sep 2021
                21 September 2021
                : 12
                : 3
                : 213-221
                Affiliations
                [1] Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India
                [1 ] Department of Oral Medicine and Radiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
                [2 ] Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
                [3 ] Department of Oral Pathology and Microbiology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
                [4 ] Department of Oral Pathology and Microbiology, The Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
                [5 ] Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
                Author notes
                Address for correspondence: Dr. Khadijah Mohideen, Department of Oral Pathology and Microbiology, Sathyabama Dental College and Hospital, Sathyabama Institute of Science and Technology, Jeppiaar Nagar, Rajiv Gandhi Salai, Chennai - 600 119, Tamil Nadu, India. E-mail: dr.khadijahm@ 123456gmail.com
                Article
                CCD-12-213
                10.4103/ccd.ccd_466_20
                8525813
                34759676
                0870ba75-ba98-416c-97d4-9b72993600e2
                Copyright: © 2021 Contemporary Clinical Dentistry

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 29 May 2020
                : 22 June 2020
                : 13 August 2020
                Categories
                Review Article

                Dentistry
                oral cancer,oral squamous cell carcinoma,younger adults
                Dentistry
                oral cancer, oral squamous cell carcinoma, younger adults

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