Mechanistic considerations in the molecular epidemiology of head and neck cancer.

Head and neck cancer occurs through a complex multistage process that is likely to involve a combination of carcinogen exposure and genetic susceptibility. The primary cause of head and neck cancer are alcohol consumption and cigarette smoking, although the carcinogenic mechanism for these agents is unclear. Molecular epidemiological studies of head and neck cancer can help to clarify the carcinogenic process in several ways, including identification of metabolizing genes which increase the risk of head and neck cancer, identification of DNA adducts in target cells and analysis of specific gene mutations and their relationship with exposure. This review summarizes current knowledge on the molecular epidemiology of head and neck cancer and attempts to identify those areas where future studies may prove fruitful.