Susanne Flach1,2, Pavithran Maniam3, Jaiganesh Manickavasagam1. 1. Department of Otorhinolaryngology and Head & Neck Surgery and Tayside Medical Sciences Centre, Ninewells Hospital, Dundee, UK. 2. Department of Otorhinolaryngology and Head & Neck Surgery, Hospital of the Ludwig-Maximilians-University, Munich, Germany. 3. University of Dundee School of Medicine, Dundee, UK.
Abstract
BACKGROUND: Cigarette smoking is a well-established risk factor for head and neck (HN) cancers. Use of electronic cigarettes (e-cigarettes) is gaining popularity, being advertised as benign alternatives to tobacco. A wide variety of potentially harmful chemical components with variable quantity have been identified in e-liquids and aerosols of e-cigarettes. However, use of e-cigarettes remains controversial due to conflicting evidence. OBJECTIVES: We aimed to assess the association between e-cigarettes and HN cancers. We conducted a systematic review to evaluate the literature for evidence on carcinogenic effects of e-cigarettes in the pathogenesis of HN cancers. TYPE OF REVIEW: Qualitative systematic review. SEARCH STRATEGY: A PubMed/MEDLINE, Cochrane, CINAHL Plus, Trip Medical Database and Web of Science search was done for studies on e-cigarettes and HN cancer. EVALUATION METHOD: Abstract review of all articles, full article revision of included studies, data extraction and quality assessment were performed by two independent assessors. RESULTS: The literature search resulted in the identification of 359 articles. Eighteen articles were selected for inclusion into the systematic review. The majority were laboratory-based studies, followed by several cohort and case studies, representing low-level evidence. A few reports suggested DNA damage following exposure to e-cigarettes potentially due to increased oxidative stress. Flavoured e-liquids appear to be more harmful. There is variable evidence from clinical studies. CONCLUSIONS: Our review outlines potential dangers associated with the use of e-cigarettes and their role in HN cancers. More longitudinal and controlled studies are needed to assess the possible link between e-cigarettes and HN cancers.
BACKGROUND: Cigarette smoking is a well-established risk factor for head and neck (HN) cancers. Use of electronic cigarettes (e-cigarettes) is gaining popularity, being advertised as benign alternatives to tobacco. A wide variety of potentially harmful chemical components with variable quantity have been identified in e-liquids and aerosols of e-cigarettes. However, use of e-cigarettes remains controversial due to conflicting evidence. OBJECTIVES: We aimed to assess the association between e-cigarettes and HN cancers. We conducted a systematic review to evaluate the literature for evidence on carcinogenic effects of e-cigarettes in the pathogenesis of HN cancers. TYPE OF REVIEW: Qualitative systematic review. SEARCH STRATEGY: A PubMed/MEDLINE, Cochrane, CINAHL Plus, Trip Medical Database and Web of Science search was done for studies on e-cigarettes and HN cancer. EVALUATION METHOD: Abstract review of all articles, full article revision of included studies, data extraction and quality assessment were performed by two independent assessors. RESULTS: The literature search resulted in the identification of 359 articles. Eighteen articles were selected for inclusion into the systematic review. The majority were laboratory-based studies, followed by several cohort and case studies, representing low-level evidence. A few reports suggested DNA damage following exposure to e-cigarettes potentially due to increased oxidative stress. Flavoured e-liquids appear to be more harmful. There is variable evidence from clinical studies. CONCLUSIONS: Our review outlines potential dangers associated with the use of e-cigarettes and their role in HN cancers. More longitudinal and controlled studies are needed to assess the possible link between e-cigarettes and HN cancers.
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