Laryngeal cancer in nondrinker nonsmoker young patients: a distinct pathological entity?

Abstract

Purpose of review: Laryngeal cancer published literature was reviewed, with emphasis on reporting on young patients (<40 years). With such information, to comment on the evidence or not, that such patients, should they be nondrinkers and nonsmokers, have a differing cause and genetic/molecular profile rather than a spectrum of the classic disease.

Recent findings: Head and neck cancer in young patients is documented at a rate of 0.4-3.6%, with laryngeal cancer being identified in less than 2% of all diagnosed head and neck cancer patients overall. Head and neck cancer in nondrinking nonsmokers has been reported from tertiary clinical hospitals only, with few patients having a diagnosis of laryngeal cancer, and thus their documented drinking and smoking habits may be considered suspect. Most of the molecular or genetic studies on young patients, who probably have had varying degrees of drinking and smoking habits, have been reported on nonlaryngeal head and neck sites. These finding should be confirmed on a 'pure group' of young patients (<40 years) with laryngeal cancer who confirm that they have been nondrinkers, and nonsmokers.

Summary: Many authors comment that laryngeal cancer in young (<40 years) nondrinking nonsmoking patients is likely explained by some molecular or genetic level abnormality rather than histological and should be considered a distinct group. However, because of a low incidence of such patients and the rapid development in genetic sequencing, that such a project be completed requires greater collaboration between clinicians and pathologists.