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Review
. 2017 Sep;36(3):411-423.
doi: 10.1007/s10555-017-9689-6.

Tobacco-related carcinogenesis in head and neck cancer

Ashok R Jethwa  1 , Samir S Khariwala  2
Affiliations
Review

Tobacco-related carcinogenesis in head and neck cancer

Ashok R Jethwa et al. Cancer Metastasis Rev. 2017 Sep.

Abstract

Head and neck cancer (head and neck squamous cell carcinoma (HNSCC)) is a devastating disease. Patients require intensive treatment that is often disfiguring and debilitating. Those who survive are often left with poor speech articulation, difficulties in chewing and swallowing, and cosmetic disfigurement, as well as loss of taste. Furthermore, given that HNSCC survivors are frequently disabled and unable to return to work, the economic and societal costs associated with HNSCC are massive. HNSCC is one of many cancers that are strongly associated with tobacco use. The risk for HNSCC in smokers is approximately ten times higher than that of never smokers, and 70-80% of new HNSCC diagnoses are associated with tobacco and alcohol use. Tobacco products have been used for centuries; however, it is just within the last 60-70 years that we have developed an understanding of their damaging effects. This relatively recent understanding has created a pathway towards educational and regulatory efforts aimed at reducing tobacco use. Understanding the carcinogenic components of tobacco products and how they lead to HNSCC is critical to regulatory and harm reduction measures. To date, nitrosamines and other carcinogenic agents present in tobacco products have been associated with cancer development. The disruption of DNA structure through DNA adduct formation is felt to be a common mutagenic pathway of many carcinogens. Intense work pertaining to tobacco product constituents, tobacco use, and tobacco regulation has resulted in decreased use in some parts of the world. Still, much work remains as tobacco continues to impart significant harm and contribute to HNSCC development worldwide.

Keywords: Head and neck squamous cell carcinoma; History of tobacco; Tobacco carcinogenesis; Tobacco products; Tobacco regulation.

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Conflict of interest statement

Conflicts of Interest: None

Figures

Figure 1
Figure 1
Death rate from cancer of the lung and rate of consumption of tobacco and cigarettes [6].
Figure 2
Figure 2
Example of tobacco advertising in the 1950s [5].
Figure 3
Figure 3
“A Frank Statement to Cigarette Smokers.” Published in 1954 by the Tobacco Industry Research Committee.
Figure 4
Figure 4
Trends in tobacco use and lung cancer deaths in the United States, 1900–2009. ACS 2013.
Figure 5
Figure 5
Prevalence (%) of current use of smokeless tobacco in men and women. Taken from NIH Publication No. 14-7983; 2014 [19].
Figure 6
Figure 6
Age standardized smoking prevalence among men, 2012. Taken from JAMA. 2014;311(2):183–192 [20].
Figure 7
Figure 7
Structures of tobacco specific nitrosamines and tobacco alkaloid precursors. NNA, 4-(methylnitrosamino)-4-(3-pyridyl)butanal; NAB, N′-nitrosoanabasine; NAT, N′-nitrosoanatabine; NNAL, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol; NNAC, 4-(methylnitrosamino)-4-(3-pyridyl)butanoic acid. Hecht, 1998 [32].
Figure 8
Figure 8
Complex relationship between tobacco, metabolism, genetic alterations, and DNA repair in carcinogenesis. Hecht, 2003 [37]
See this image and copyright information in PMC

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