Hussein Aisha A, Helder Marco N, de Visscher Jan G, Leemans C René, Braakhuis Boudewijn J, de Vet Henrica C W, Forouzanfar Tymour
Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands.
Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Eur J Cancer. 2017 Sep;82:115-127. doi: 10.1016/j.ejca.2017.05.026. Epub 2017 Jun 24.
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.
头颈部鳞状细胞癌（HNSCC）通常被认为是一种老年人疾病。然而，近年来全球范围内报告的年龄较轻（定义为<45岁）的HNSCC患者数量不断增加。为了评估全球年轻患者口腔癌和口咽癌发病率的地理差异和趋势，我们在PubMed和谷歌学术数据库中对1975年至2016年6月期间进行了系统综述。共筛选出78项研究进行进一步分析。来自13个国家的19项基于人群的发病率研究表明，除荷兰外，发病率随时间显著上升。观察到白人女性口腔（活动）舌癌和白人男性口咽癌显著增加。数据表明，年轻患者的癌症可能是一种独特的临床实体，并具有不同的病因和发病机制。此外，年轻患者口腔癌和口咽癌在总发病率中的相对比例在北美（5.5%）与非洲（17.2%）和中东（14.5%）的估计值之间存在显著差异。研究得出以下结论：（i）全球年轻患者口腔癌和口咽癌呈上升趋势；（ii）发病率研究应在年龄队列中正确定义结果，并对年轻患者采用一致的年龄界限；（iii）应在非西方地区开展更多基于人群的研究，以准确衡量这些癌症在年轻亚人群中的全球发病率；（iv）迫切需要确定这些年轻患者的新病因。
