Modifiable risk factors for oral cavity cancer in non-smokers: A systematic review and meta-analysis

Margaret A Heller; Sarah C Nyirjesy; Robert Balsiger; Nicholas Talbot; Kyle K VanKoevering; Catherine T Haring; Matthew O Old; Stephen Y Kang; Nolan B Seim

doi:10.1016/j.oraloncology.2022.106300

Modifiable risk factors for oral cavity cancer in non-smokers: A systematic review and meta-analysis

Oral Oncol. 2023 Feb:137:106300. doi: 10.1016/j.oraloncology.2022.106300. Epub 2023 Jan 11.

Authors

Margaret A Heller¹, Sarah C Nyirjesy¹, Robert Balsiger¹, Nicholas Talbot¹, Kyle K VanKoevering¹, Catherine T Haring¹, Matthew O Old¹, Stephen Y Kang¹, Nolan B Seim²

Affiliations

¹ Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States.
² Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States. Electronic address: Nolan.Seim@osumc.edu.

PMID: 36638697
DOI: 10.1016/j.oraloncology.2022.106300

Abstract

Background: Oral cavity cancer (OCC) is traditionally associated with smoking, but there is an increasing prevalence of the disease among non-smokers. This review investigates possible modifiable risk factors in the development of OCC in non-smokers (OCCNS).

Methods: PubMed, EMBASE, Web of Science, and Scopus were searched for publications prior to June 2021. Comparative studies investigating modifiable OCCNS risk factors were identified following PRISMA guidelines. Publication date, population size, and results were indexed. Study quality was assessed using MINORS (Methodological Index for Non-Randomized Studies). Factors examined by multiple studies were analyzed using random-effect meta-analysis framework.

Results: Literature search resulted in 1,625 unique publications. 52 records met inclusion criterion, investigating alcohol (n = 22), chewing products (n = 18), diet (n = 7), dental health (n = 11), and medical comorbidities (n = 6).

Conclusion: This review demonstrates the paucity of large studies investigating OCCNS risk factors. Further investigation is warranted to help clinicians risk-stratify patients without traditional risk factors.

Keywords: Head and neck neoplasms; Meta analysis; Mouth neoplasms; Non-smokers; Primary prevention; Risk factors; Squamous cell carcinoma of head and neck; Systematic review.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Humans
Mouth Neoplasms* / epidemiology
Mouth Neoplasms* / etiology
Non-Smokers*
Risk Factors
Smoking / adverse effects