Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma.
Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma.
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DOI：
10.3390/medsci11020042
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发表时间：
2023-06-13
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头颈部鳞状细胞癌(HNSCC)是一组恶性肿瘤，累及口腔、咽、下咽、喉、鼻腔和唾液腺，共同构成全球第七大最常见的癌症诊断。据GLOBOCAN估计，每年有89万新病例和45万人死亡，HNSCC约占癌症诊断和死亡的4.5%。在发展中国家，随着烟草(烟熏或咀嚼)、酒精和槟榔(槟榔)消费量的增加，HNSCC的发病率也在增加。酒精和烟草具有协同作用，大量饮用两者都会使HNSCC风险增加40倍。在发达国家，与HPV相关的HNSCC超过了与烟草和酒精相关的疾病。与口腔相比，HPV相关性HNSCC更常见于口咽、下咽和喉部，并且与显著延长的中位生存期有关(130个月对20个月)。病因上的差异，以及生活方式选择和获得医疗保健的机会方面的差异，可能是发达国家少数族裔和社会经济地位较低的社区HNSCC发病率较高、存活率较低的原因。药物治疗和咨询一起被证明在促进吸烟和戒酒方面是有效的。关于癌症风险的教育和社区参与减少了亚洲和散居海外社区的槟榔消费。从11-12岁开始接种HPV疫苗，无论男女，都已被证明可以降低高危HPV血清的流行率，并预防宫颈、阴道和外阴的癌前病变。截至2020年，美国58.6%的合格青少年接种了完整的两种疫苗系列。更多地采用疫苗接种、安全性行为教育以及对高危患者进行常规的视觉口腔筛查将遏制发达国家日益增长的HNSCC发病率。
Head and neck squamous cell carcinoma (HNSCC) is a group of malignancies, involving the oral cavity, pharynx, hypopharynx, larynx, nasal cavity, and salivary glands, that together compose the seventh most common cancer diagnosis worldwide. With 890,000 new cases and 450,000 deaths annually per GLOBOCAN estimates, HNSCC accounts for roughly 4.5% of cancer diagnoses and deaths. In the developing world, the incidence of HNSCC is growing with increasing consumption of tobacco (smoked or chewed), alcohol, and areca nut (betel quid). Alcohol and tobacco have a synergistic effect, with the heavy consumption of both increasing HNSCC risk 40-fold. In developed nations, HPV-related HNSCC surpasses tobacco- and alcohol-related disease. HPV-related HNSCC more commonly affects the oropharynx, hypopharynx, and larynx than the oral cavity, and is associated with a significantly longer median survival (130 months vs. 20 months). Discrepancies in etiology as well as disparities in lifestyle choices and access to healthcare may account for the greater incidence and poorer survival of HNSCC among minority and lower-socioeconomic-status communities in developed nations. Pharmacotherapy and counseling together have been shown to be effective in promoting smoking and alcohol cessation. Education on cancer risk and community engagement have reduced areca nut consumption in Asia as well as in diaspora communities. HPV vaccination, starting at age 11–12 for both sexes, has been shown to reduce the prevalence of high-risk HPV serologies and prevent pre-cancerous lesions of the cervix, vagina, and vulva. As of 2020, 58.6% of eligible adolescents in the US have received the full two-vaccine series. Increased adoption of vaccination, education on safe sex practices, and routine visual oral screening for high-risk patients would curb growing HNSCC incidence in developed nations.