New York Presbyterian Hospital Columbia & Cornell Universities, New York, New York, USA.
J Otolaryngol Head Neck Surg. 2010 Feb;39(1):76-89.
(1) To assess the knowledge of a group of experts in head and neck cancer regarding risk factors for oral cancer; (2) to describe the quality of the available literature on the topic of oral cancer risk factors; and (3) to compare expert opinion about oral cancer risk factors with the literature.
Survey of head and neck cancer experts and extensive literature review and classification of levels of evidence for published data.
Extensive data demonstrating the level of published literature support for or against many compounds and behaviours are presented. In several cases, there was good correlation between expert opinions and literature support, whereas for others, there was a clear discordance.
Experts in oral cancer are in agreement that tobacco smoking and betel use are significant risk factors for the development of oral cavity carcinoma. There is a lack of agreement about the risks of alcohol, poor-fitting dentures, maté tea, and a diet low in fruits and vegetables. Sufficient data have been published demonstrating the risk associated with each factor; however, it appears that the most current data and research are not as available to medical professionals as they should be. The perceived risks of tobacco chewing and use of khat were not substantiated by a solid foundation of data. A higher degree of concordance among experts was found for riskier health habits such as tobacco, alcohol, and betel chewing, whereas the votes were more dispersed for the risk factors that received lower ratings.
(1) 评估一组头颈部癌症专家对口腔癌危险因素的认识;(2) 描述口腔癌危险因素主题相关文献的质量;(3) 将专家对口腔癌危险因素的意见与文献进行比较。
对头颈癌专家进行调查,并对现有文献进行广泛的回顾和分类,以确定已发表数据的证据水平。
本文展示了大量数据,证明了许多化合物和行为的已发表文献对其的支持或反对程度。在某些情况下,专家意见与文献支持之间存在很好的相关性,而在其他情况下,则存在明显的不一致。
口腔癌专家一致认为,吸烟和嚼槟榔是口腔癌发展的重要危险因素。对于酒精、不合适的义齿、马黛茶和低水果和蔬菜饮食的风险存在分歧。已经发表了足够的数据来证明与每个因素相关的风险;然而,似乎最新的数据和研究并没有像应该的那样提供给医疗专业人员。人们普遍认为咀嚼烟草和使用卡特叶的风险没有坚实的数据基础来支撑。对于像吸烟、饮酒和嚼槟榔这样风险较高的健康习惯,专家之间的一致性更高,而对于风险评级较低的危险因素,投票则更加分散。