Early onset oral tongue squamous cell carcinoma: Associated factors and patient outcomes

Head Neck. 2019 Jun;41(6):1952-1960. doi: 10.1002/hed.25650. Epub 2019 Jan 11.

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.

Keywords: oral tongue; snuff; squamous cell carcinoma; tobacco; young.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Carcinoma, Squamous Cell / epidemiology*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Combined Modality Therapy
  • Female
  • Health Behavior
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Survival Rate
  • Tobacco, Smokeless
  • Tongue Neoplasms / epidemiology*
  • Tongue Neoplasms / pathology
  • Tongue Neoplasms / therapy