Oral cavity and oropharyngeal squamous cell carcinoma in young adults: a review of the literature

Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is a disease of middle-aged to elderly adults. However, an increased incidence of HNSCC in young people under 45 years of age has been reported recently. In the present review, we focused on the epidemiology and aetiology of HNSCC in adults under 45 years of age.

Methods: We reviewed literature related to HNSCC in adult patients less than 45 years of age and discussed current treatment options and prognosis.

Results: HNSCC in young adults is associated with a higher incidence rate in nonsmokers, lower female-to-male ratio, a higher percentage of oral cavity and oropharynx tumours, and fewer second primary tumours. However, aside from traditional risk factors of tobacco and alcohol exposure, the causes of these cancers in young adults remain unclear. Agents that might contribute to risk include infection with high-risk human papillomavirus subtypes as well as genetic factors or immunodeficiency status. The expected increase in incidence and mortality of the young with HNSCC may become a major public health concern if current trends persist, particularly lifestyle habits that may contribute to this disease.

Conclusions: Given the younger age and potential long-term adverse sequelae of traditional HNSCC treatments, young adults should be treated on a case-by-case basis and post-therapy quality of life must be considered in any treatment-decision making process.

Keywords: head and neck cancer; quality of life; squamous cell carcinoma; young adults.

FIGURE 1.

Oropharyngeal Cancer Patients (segregated by age, presence of HPV-16 infection and smoking).

FIGURE 2.

Proposal of an integrated model of molecular carcinogenesis for head and neck squamous cell carcinoma according to Leemans et al.