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Review
. 2024 Sep 20:14:1452909.
doi: 10.3389/fonc.2024.1452909. eCollection 2024.

Oral cancer in young adults: incidence, risk factors, prognosis, and molecular biomarkers

Deborah Lenoci #  1 , Elisa Moresco #  2 , Stefano Cavalieri  2   3 , Cristiana Bergamini  2 , Erica Torchia  1 , Laura Botta  4 , Silvana Canevari  5 , Annalisa Trama  4 , Lisa Licitra #  2   3 , Loris De Cecco #  1
Affiliations
Review

Oral cancer in young adults: incidence, risk factors, prognosis, and molecular biomarkers

Deborah Lenoci et al. Front Oncol. .

Abstract

Oral cavity squamous cell carcinoma (OCSCC) predominantly affects the tongue and the floor of the mouth, primarily in patients over 50 years of age. Incidence and mortality rates vary significantly worldwide, influenced by geographic areas and demographic characteristics. Epidemiological studies revealed an increase in incidence of OCSCC among young adults (YA) <44 years old. This narrative review, provides updated information on the incidence, risk factors, and prognosis of YA-OCSCC using data published from 2018 to 2023 from different geographic locations. The studies indicate that the incidence of YA-OCSCC in Asia is approximately twice that in the US and that the incidence is strongly linked to risk factors such as betel quid chewing, tobacco use, and high alcohol consumption. The prognosis for YA-OCSCC, compared to that in older patients, shows similar or better overall survival, even in cases with relapses, but worse 5-year disease-free survival, despite receiving similar treatments. Consequently, a concerted effort is crucial to raise awareness about the cessation of tobacco and areca nut use, alcohol control, and the promotion of healthy lifestyle behaviors. Recent molecular data on YA-OCSCC suggests a potential profile characterized by epidermal growth factor receptor overexpression, low tumor mutation burden and an attenuated immune response. Upon confirmation in larger cohorts of YA-OCSCC patients from different geographical areas, the validated markers could aid in selecting tailored treatments.

Keywords: incidence; molecular data; oral cavity squamous cell carcinoma; outcome; risk factors; young adult.

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Conflict of interest statement

LL declares the following conflicts of interest: research funds donated directly to the institute for clinical trials from AstraZeneca, BMS, Boehringer Ingelheim, Celgene International, Eisai, Exelixis, Debiopharm International SA, Hoffmann-La Roche Ltd, IRX Therapeutics, Medpace, Merck-Serono, MSD, Novartis, Pfizer, Roche, and Buran; occasional fees for participation as a speaker at conferences/congresses or as a scientific consultant for advisory boards from AstraZeneca, Bayer, MSD, Merck-Serono, AccMed, Neutron Therapeutics, Inc., and Alentis. SC declares occasional fees for participation as a speaker at conferences/congresses from AccMed; support for attending meetings and/or travel from AccMed, MultiMed Engineers srl, Care Insight sas. The remaining authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A, C) Number of new oral cavity cancer cases in 2022 and (B, D) estimated changes in 2045. Reprinted with permission from the online data visualization tools for exploring the global cancer burden provided by the IARC (International Agency for Research on Cancer) Global Cancer Observatory. Figures “Cancer Today. Absolute numbers, Incidence, Both sexes, in 2022. Lip, oral cavity. Continents”, “Cancer Today. Absolute numbers, Incidence, Both sexes, age [0-44], in 2022. Lip, oral cavity. Continents”, “Cancer Today. Age-Standardized Rate (World) per 100 000, Incidence, Both sexes, in 2022. Lip, oral cavity. Continents”, “Cancer Today. Age-Standardized Rate (World) per 100 000, Incidence, Both sexes, age [0-44], in 2022. Lip, oral cavity. Continents” Respective URLs (accessed on 17th June 2024): https://gco.iarc.fr/today/en/dataviz/pie?mode=population&group_populations=0&cancers=1 https://gco.iarc.fr/today/en/dataviz/pie?mode=population&group_populations=0&cancers=1 &age_end=8&populations=903_904_905_908_909_935 https://gco.iarc.fr/today/en/dataviz/bars?mode=population&cancers=1 https://gco.iarc.fr/today/en/dataviz/bars?mode=population&cancers=1&age_end=8 Copyright 2024. Permission from IARC obtained on 17th June 2024.
Figure 2
Figure 2
Graphical representation of the factors involved in the development of YA-OCSCC (ranked by probability). Created with BioRender.com.
See this image and copyright information in PMC

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