Squamous cell carcinoma of the oral cavity, pharynx, and larynx in young adults.

Thirty-nine adults (34 male, 5 female) age 40 or under with squamous cell carcinoma of the head and neck (excluding nasopharyngeal carcinoma) were seen at the Baylor College of Medicine affiliated hospitals from 1964 to 1983. The average age of the patients was 36.3 years and they were nearly uniformly heavy smokers and drinkers. Twenty-six of the 39 patients were black. Lesions of the oral cavity and oropharynx were most frequent, followed by laryngeal lesions. Four patients presented with second primary tumors, and one patient had three separate lesions. Of the 39 patients, only 8 had cancers small enough to be considered curable by radiotherapy or organ-sparing surgery. The remainder of the patients required radical surgery (26), were considered incurable at the time of presentation (8), or refused treatment (3). Also noted was a relatively high incidence of prior trauma (gunshot wounds, laparotomies for trauma). Of 30 patients available for follow-up more than one year after treatment, 19 have died of their tumors. Only one patient had a documented immune disorder (systemic lupus). In contrast to previous authors, we conclude that the development of squamous cell carcinoma at a young age can be related to heavy smoking and drinking and that the poor survival in many patients is due to self-neglect and failure to seek medical care early in the course of the disease.