Benjamin R Campbell1, Courtney B Sanders2, James L Netterville3, Robert J Sinard3, Sarah L Rohde3, Alexander Langerman3, Kyle Mannion3, Young J Kim3, Barbara A Murphy4, James S Lewis5, Jeremy L Warner4, Derek K Smith6, Krystle A Lang Kuhs3. 1. Vanderbilt University School of Medicine, Nashville, Tennessee, USA. 2. Vanderbilt University, Nashville, Tennessee, USA. 3. Vanderbilt University Medical Center, Department of Otolaryngology, Nashville, Tennessee, USA. 4. Vanderbilt University Medical Center, Department of Medicine, Division of Hematology and Oncology, Nashville, Tennessee, USA. 5. Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, Nashville, Tennessee, USA. 6. Vanderbilt University Medical Center, Department of Biostatistics, Nashville, Tennessee, USA.
Abstract
BACKGROUND: Incidence of oral tongue squamous cell carcinoma (OTC) is rising among those under age 50 years. The etiology is unknown. METHODS: A total of 395 cases of OTC diagnosed and/or treated at Vanderbilt University Medical Center between 2000 and 2017 were identified. Of those, 113 (28.6%) were early onset (age < 50 years). Logistic regression was used to identify factors associated with early onset OTC. Cox proportional hazards models evaluated survival and recurrence. RESULTS: Compared to typical onset patients, patients with early onset OTC were more likely to receive multimodality treatment (surgery and radiation; adjusted odds ratio [aOR], 2.7; 95% confidence interval [CI], 1.2-6.3) and report a history of snuff use (aOR, 5.4; 95% CI, 1.8-15.8) and were less likely to report a history of cigarette use (aOR, 0.5; 95% CI, 0.2-0.9). Early onset patients had better overall survival (adjusted hazard ratio, 0.6). CONCLUSIONS: This is the largest study to evaluate factors associated with early onset OTC and the first to report an association with snuff.
BACKGROUND: Incidence of oral tongue squamous cell carcinoma (OTC) is rising among those under age 50 years. The etiology is unknown. METHODS: A total of 395 cases of OTC diagnosed and/or treated at Vanderbilt University Medical Center between 2000 and 2017 were identified. Of those, 113 (28.6%) were early onset (age < 50 years). Logistic regression was used to identify factors associated with early onset OTC. Cox proportional hazards models evaluated survival and recurrence. RESULTS: Compared to typical onset patients, patients with early onset OTC were more likely to receive multimodality treatment (surgery and radiation; adjusted odds ratio [aOR], 2.7; 95% confidence interval [CI], 1.2-6.3) and report a history of snuff use (aOR, 5.4; 95% CI, 1.8-15.8) and were less likely to report a history of cigarette use (aOR, 0.5; 95% CI, 0.2-0.9). Early onset patients had better overall survival (adjusted hazard ratio, 0.6). CONCLUSIONS: This is the largest study to evaluate factors associated with early onset OTC and the first to report an association with snuff.
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