Global incidence of oral and oropharynx cancer in patients younger than 45 years versus older patients: A systematic review

• Published in: European journal of cancer (1990) Vol. 82; pp. 115 - 127
• Main Authors: Hussein, Aisha A., Helder, Marco N., de Visscher, Jan G., Leemans, C. René, Braakhuis, Boudewijn J., de Vet, Henrica C.W., Forouzanfar, Tymour
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-09-2017; Elsevier Science Ltd
• Subjects: Adult; Age; Cancer; Geographical variations; Geriatrics; Global Health; Head & neck cancer; Humans; Incidence; Incidence rate; Mouth Neoplasms - epidemiology; Older people; Oral cancer; Oropharyngeal cancer; Oropharyngeal Neoplasms - epidemiology; Oropharynx; Oropharynx cancer; Pathogenesis; Patients; Population studies; Relative proportion; Scientific papers; Squamous cell carcinoma; Subpopulations; Systematic review; Throat cancer; Tongue; Trends; Young Adult; Young patients; Oropharynx cancer; Young patients; Incidence rate; Oral cancer; Relative proportion
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2017.05.026

Head and neck squamous cell carcinoma (HNSCC) is typically regarded as a disease of elderly people. However, increasing numbers of patients worldwide with HNSCC at younger age (defined as <45 years old) have been reported in recent years.
To assess geographical variations and trends worldwide in incidence of oral and oropharyngeal cancer in young patients, a systematic review was conducted in PubMed and Google scholar databases from 1975 to June 2016. Seventy-eight studies were selected for further study.
Nineteen population-based studies on incidence rate were available from 13 countries, showing a prominent increase over time except for the Netherlands. A notable rise of oral (mobile) tongue cancer among white women and oropharyngeal cancer in white men was observed. Data suggest that cancer in young patients may be a distinct clinical entity and characterised by different aetiology and pathogenesis. Additionally, the relative proportion of oral and oropharyngeal cancer in young patients to total incidence revealed a significant difference between estimates from North America (5.5%) and both Africa (17.2%) and Middle East (14.5%).
It is concluded that (i) a rising trend in oral and oropharynx cancers is observed in young patients worldwide; (ii) incidence studies should properly define outcomes in age cohorts and use a consensus cut-off for young patients; (iii) more population-based studies should be performed in non-Western regions to get accurate global measures of incidence for these cancers in young subpopulations and (iv) there is an urge to identify new aetiological factors in these young patients.
•This systematic review assesses the global head and neck squamous cell carcinoma (HNSCC) incidence in young adults (<45 year).•In this group, a worldwide rising trend in HNSCC is observed.•Relative proportions of ‘young’ HNSCC versus total incidence vary between continents.•Data suggest that cancer in young patients may be a distinct clinical entity.•There is an urge to identify new aetiological factors in these young patients.