Monaghan Neil P, Duckett Kelsey A, Nguyen Shaun A, Newman Jason G, Kejner Alexandra E, Albergotti W Greer
Department of Otolaryngology-Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA.
College of Medicine Medical University of South Carolina Charleston South Carolina USA.
World J Otorhinolaryngol Head Neck Surg. 2024 Jun 27;11(1):138-146. doi: 10.1002/wjo2.198. eCollection 2025 Mar.
To assess the incidence of head and neck cancer in patients exposed to Agent Orange and related dioxins.
Studies were identified through CINAHL, PubMed, and Scopus. Primary studies were identified through April 2023. Articles were included reporting incidence of head and neck cancer and/or deaths due to head and neck cancer in participants exposed to Agent Orange. Meta-analysis of proportions was conducted to calculate incidence and mortality by primary site in those who were exposed to Agent Orange and for control groups. A comparison of proportions was used to compare rates in exposed and control groups.
Of 1530 unique abstracts screened, 13 studies were included in the systematic review. Of the exposed patients with reported subsites, oral cavity (31.2%), and larynx (14%) were the most common. Of the exposed patients with reported deaths and subsites, oropharynx (0.25%) was the most common primary site in patients who died. The most common subsites of those who were not exposed, oropharynx (0.13%), and larynx (0.16%). Head and neck cancer of all subsites was more common in those exposed to Agent Orange than in unexposed controls (difference 0.061%; 95% confidence interval: 0.04%-0.08%, < 0.0001).
Our findings suggest that head and neck cancer is more common in those who were exposed to Agent Orange than those who were not. Additionally, individuals exposed to Agent Orange were more likely to die from head and neck cancer. Further investigation is warranted to evaluate subsite-specific outcomes given the limitations of our study design.
评估接触橙剂及相关二噁英的患者中头颈癌的发病率。
通过护理学与健康领域数据库（CINAHL）、医学期刊数据库（PubMed）和文摘与引文数据库（Scopus）检索相关研究。截至2023年4月确定了原始研究。纳入的文章报告了接触橙剂的参与者中头颈癌的发病率和/或因头颈癌导致的死亡情况。对比例进行荟萃分析，以计算接触橙剂者和对照组按主要部位划分的发病率和死亡率。采用比例比较法比较暴露组和对照组的发病率。
在筛选的1530篇独特摘要中，有13项研究纳入了系统评价。在报告了亚部位的暴露患者中，口腔（31.2%）和喉（14%）是最常见的部位。在报告了死亡情况和亚部位的暴露患者中，口咽（0.25%）是死亡患者中最常见的原发部位。未暴露者中最常见的亚部位是口咽（0.13%）和喉（0.16%）。接触橙剂者所有亚部位的头颈癌比未接触者更常见（差异0.061%；95%置信区间：0.04%-0.08%，P<0.0001）。
我们的研究结果表明，接触橙剂者比未接触者患头颈癌更为常见。此外，接触橙剂的个体死于头颈癌的可能性更大。鉴于我们研究设计的局限性，有必要进一步调查以评估亚部位特异性结局。
