Epidemiology of Oral Cancers

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Questions and Answers

Which characteristic is NOT typical of cancer?

  • Ability to invade distant organs
  • Spontaneous healing without treatment (correct)
  • Ability to invade adjacent tissues
  • Abnormal growth of cells

What defines oral cancer?

  • Presence of pain in all cases
  • Exclusively linked with skin cancers
  • An indurated, ulcerated lump or sore (correct)
  • Only occurs in the tongue region

Which type of cancer is classified under oral cancers?

  • Sarcomas
  • Melanoma
  • Carcinomas (correct)
  • Leukaemias

What is NOT a learning outcome of studying the epidemiology of oral cancers?

<p>Identifying treatment options for oral cancers (A)</p> Signup and view all the answers

Oral cancer is primarily associated with which type of body region?

<p>Head and neck region cancers (D)</p> Signup and view all the answers

Which of the following factors is associated with an increased risk of oral cancers?

<p>Increased consumption of red chilly powder (D)</p> Signup and view all the answers

What environmental factor is cited as a contributor to water contamination linked to oral cancers?

<p>Chloroform pollutants (C)</p> Signup and view all the answers

Which geographic region is noted for a higher incidence of oral cancer compared to developed countries?

<p>Low/middle-income countries (C)</p> Signup and view all the answers

In which country is the buccal mucosa most commonly affected by oral cancer?

<p>Netherlands (B)</p> Signup and view all the answers

Which of the following deficiencies is linked to an increased risk of oral cancers?

<p>Deficiency of folic acid (B)</p> Signup and view all the answers

What percentage of oral cancers are classified as squamous cell carcinomas?

<p>90 to 95% (D)</p> Signup and view all the answers

Which demographic is more likely to develop oral cancers?

<p>Older men (C)</p> Signup and view all the answers

How many deaths occur annually due to oral cancers worldwide?

<p>180,000 (D)</p> Signup and view all the answers

What is a growing cause of oral cancers among young people in North America and Europe?

<p>Human papillomavirus infections (A)</p> Signup and view all the answers

Which of the following is not a listed host factor for oral cancers?

<p>Geographic variations (A)</p> Signup and view all the answers

Which type of oral cancer has the highest incidence globally?

<p>Squamous cell carcinoma (A)</p> Signup and view all the answers

Which factor is considered a chemical agent in the epidemiologic triad of oral cancers?

<p>Smoking (D)</p> Signup and view all the answers

Which of the following is a known environmental factor affecting the incidence of oral cancers?

<p>Water contaminants (D)</p> Signup and view all the answers

What percentage of head and neck cancers is possibly explained by tobacco use, alcohol consumption, and poor diet?

<p>90% (C)</p> Signup and view all the answers

Which demographic trend is observed concerning tobacco use among youths in developing countries?

<p>Increasing tobacco use (A)</p> Signup and view all the answers

What is the primary addictive agent in tobacco that triggers the release of dopamine?

<p>Nicotine (C)</p> Signup and view all the answers

What happens to blood flow as a result of prolonged exposure to nicotine?

<p>Decreased blood flow (A)</p> Signup and view all the answers

Which substance is classified as a strong carcinogen formed from the interaction of nicotine?

<p>Nitrosamines (A)</p> Signup and view all the answers

In Western countries, which form of tobacco use is most predominant?

<p>Cigarettes and cigars (B)</p> Signup and view all the answers

What is a consequence of nicotine reducing the host immunity?

<p>Decreased immune cell levels (A)</p> Signup and view all the answers

What are nitrosamines primarily formed from?

<p>Nitrates or nitrites and certain amines (A)</p> Signup and view all the answers

Which risk factor is commonly associated with higher rates of oral cancer in males compared to females?

<p>Higher exposure to tobacco and alcohol (C)</p> Signup and view all the answers

Which ethnic group is known to develop lip melanoma more frequently?

<p>Whites (D)</p> Signup and view all the answers

What is the most common intraoral site for oral cancer worldwide?

<p>Tongue (C)</p> Signup and view all the answers

Which of the following factors is NOT associated with the development of lip cancer?

<p>Chronic tooth decay (B)</p> Signup and view all the answers

What type of cancer mimics tooth-related benign inflammatory conditions and often has a delayed diagnosis?

<p>Gingival cancer (D)</p> Signup and view all the answers

What is a significant risk factor for the carcinoma of the tongue?

<p>Chronic irritation (D)</p> Signup and view all the answers

Which site for oral cancer is specifically identified as affecting the lower lip most commonly?

<p>Lower lip (D)</p> Signup and view all the answers

Chronic irritation in the buccal mucosa can result from which of the following factors?

<p>Cheek-biting or sharp teeth (A)</p> Signup and view all the answers

What is a significant effect of carbon monoxide on the body?

<p>It interferes with oxygen uptake in the lungs. (A)</p> Signup and view all the answers

Which of the following compounds is NOT a radioactive compound found in cigarette smoke?

<p>Arsenic (C)</p> Signup and view all the answers

Which particulate matter is primarily involved in the formation of tumor initiators in cigarette smoke?

<p>Tar (C)</p> Signup and view all the answers

What role do nitrosamines play in cancer development?

<p>They promote inflammation. (B)</p> Signup and view all the answers

Which viral agent has been implicated in the promotion of oral cancers?

<p>HIV (D)</p> Signup and view all the answers

What effect does ill-fitting dentures have as a mechanical factor in oral cancers?

<p>They cause chronic irritation. (D)</p> Signup and view all the answers

Which of the following is a chemical factor associated with oral cancers?

<p>Tobacco-specific nitrosamines (C)</p> Signup and view all the answers

Increased activity of which type of immune cell may lead to carcinogenesis according to the content?

<p>T helper 17 cells (D)</p> Signup and view all the answers

Flashcards

Epidemiology

The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.

Incidence

The number of new cases of a disease or condition that occur in a specific population during a given period.

Prevalence

The total number of cases of a disease or condition that exist in a specific population at a given point in time.

Etiological Factors

Factors that contribute to the development of a disease, such as smoking, alcohol consumption, and HPV infection.

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Oral Cancer

A type of cancer that originates in the epithelial tissues of the mouth, including the lips, tongue, cheeks, gums, and floor of the mouth.

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What is the most common type of oral cancer?

Squamous cell carcinoma is the most common type of oral cancer. It accounts for a vast majority of oral cancer cases.

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What is the global incidence of oral cancer?

Global incidence of oral cancer is estimated to be about 4 cases per 100,000 people. This means, on average, 4 out of every 100,000 people will develop oral cancer.

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Why are oral cancers a concern worldwide?

Oral cancers are among the leading causes of cancer-related deaths worldwide, with about 180,000 deaths each year. This highlights the importance of early detection and prevention.

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Who is more likely to develop oral cancer: men or women?

Oral cancer is more common in men than in women.

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How does age affect oral cancer risk?

Oral cancer incidence increases with age. Older adults are at a higher risk of developing this type of cancer.

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What is an emerging risk factor for oral cancer, especially in young people?

Human papillomavirus (HPV) infections are increasingly recognized as a cause of oral cancers, especially among younger populations in North America and Europe.

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What is the epidemiologic triad of oral cancers?

The epidemiologic triad helps explain the factors that contribute to oral cancer development. It consists of the agent (e.g., viruses, chemicals), the host (e.g., age, genetics), and the environment (e.g., pollution, sunlight).

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What are some factors that increase the risk of developing oral cancer?

Factors that contribute to oral cancer development include but are not limited to: smoking, alcohol consumption, poor oral hygiene, and exposure to certain environmental factors such as pollution and sunlight.

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What factors influence the age of oral cancer diagnosis?

The average age at which oral cancer is diagnosed varies in different countries and is linked to the prevalence of risk factors.

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How does gender affect oral cancer rates?

Men are more likely to develop oral cancer compared to women, often due to higher exposure to risk factors like alcohol and tobacco use.

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How does race or ethnicity influence oral cancer rates?

Differences in cultural practices and social factors can influence the prevalence of oral cancer among different ethnic groups.

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What is the most common site for oral cancer?

The most common site for oral cancer is the tongue, a concern worldwide, especially in regions with high rates of alcohol and tobacco use.

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What are the characteristics of lip cancer?

Lip cancer, primarily affecting the lower lip, is more common in older males and linked to factors like tobacco use, alcohol consumption, and exposure to sunlight.

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What are the factors contributing to buccal mucosa cancer?

Cancer on the buccal mucosa, the inner lining of the cheek, is often related to tobacco use, alcohol consumption, and chronic irritation caused by biting or dental devices.

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Why is gingival cancer often diagnosed late?

Gingival cancer, affecting the gums, is often diagnosed late due to its similarity to benign dental conditions, making early detection challenging.

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What is a known risk factor for oral cancer, particularly tongue cancer?

Human papillomavirus (HPV) is a known risk factor for oral cancer, especially for tongue cancer.

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What causes most head and neck cancers?

Tobacco use, alcohol consumption, and poor diet are responsible for almost 90% of head and neck cancers, including oral cancer.

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What is the annual death toll from oral cancer?

Oral cancer causes more than 140,000 deaths globally each year.

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How does nicotine make people addicted?

Nicotine, a chemical in tobacco, causes addiction by triggering the release of dopamine, a pleasure chemical in the brain.

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Is nicotine a carcinogen?

Nicotine itself may not cause cancer, but it aids in the formation of potent carcinogens called tobacco-specific nitrosamines.

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What are tobacco-specific nitrosamines?

Tobacco-specific nitrosamines are potent cancer-causing substances formed from a reaction between nitrates/nitrites and certain amines.

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How does nicotine affect the body?

Nicotine reduces blood flow, weakens the immune system, and makes the body more susceptible to cancer.

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Where is chewing tobacco more common?

Chewing tobacco is more common in Asia, and areca nut is prevalent in the Pacific Islands.

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How could the age of oral cancer diagnosis change?

Because tobacco use is declining in developed countries, oral cancer may be diagnosed earlier in younger people in developing countries.

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What is Tar?

It's the particulate matter inhaled from a lit cigarette containing nitrogen, oxygen, hydrogen, carbon dioxide, carbon monoxide, and tumor-causing compounds like polycyclic aromatic hydrocarbons (PAHs) and tobacco-specific nitrosamines.

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What is Carbon Monoxide (CO)?

It's a colorless, odorless, and poisonous gas that reduces oxygen uptake in the lungs and blood.

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What are Radioactive Compounds in Cigarette Smoke?

These are radioactive compounds found in cigarette smoke, including polonium-210, potassium-40, radium-226, radium-228, and thorium-228, known to cause cancer.

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What is Squamous Cell Carcinoma?

It's the most common type of oral cancer, arising in the epithelial tissues of the mouth.

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What are Biological Agents Contributing to Oral Cancer?

These are viruses (HIV, HPV, EBV, HSV) and fungi (Candida) that can contribute to oral cancer development.

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What are Chemical Agents Contributing to Oral Cancer?

These are chemicals like arsenic, dyes, nickel, aromatic amines, and chromium that can increase oral cancer risk.

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What are Mechanical Agents Contributing to Oral Cancer?

These are physical factors, like sharp teeth and ill-fitting dentures, that can irritate the mouth and contribute to oral cancer.

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What are Host Factors Influencing Oral Cancer?

These are factors like age, genetics, and immune system function that influence an individual's susceptibility to oral cancer.

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What are some precarcinogens found in food?

Certain foods and substances that can increase the risk of developing cancer. These include saccharin, aflatoxin, high fat intake, and deficiencies in folic acid and protein. Excessive red chili powder consumption, as well as low levels of copper, zinc, vegetables, vitamin E, and C, can also contribute to cancer risk.

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What is a key water contaminant linked to cancer?

It includes some organic pollutants like chloroform, which can contaminate drinking water and be linked to cancer development.

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How does industrialization contribute to cancer risk?

Industrialization is a risk factor for cancer because industries release harmful toxins into the environment, polluting water sources and the air we breathe. This contaminated environment can contribute to cancer development.

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How does geographic location influence oral cancer rates?

Oral cancer incidence varies based on location. Prevalence rates are often higher in developing countries compared to developed countries due to factors like access to healthcare and exposure to risk factors.

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Where are oral cancer rates generally higher, in developed or developing countries?

The incidence of oral cancer tends to be higher in lower/middle income countries and developing countries compared to developed countries. Possible reasons include lifestyle factors, accessibility to healthcare, and exposure to various carcinogens.

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Study Notes

Epidemiology of Oral Cancers

  • Oral cancer is one of the ten leading cancers globally.
  • It's characterized by abnormal cell growth, ability to invade tissues/organs, and eventual patient death if progression is extensive.
  • Common cancer types include carcinomas, sarcomas, melanoma, lymphomas, and leukemias.
  • Oral cancer presentation often includes an indurated, ulcerated lump or sore, sometimes painless, frequently associated with cervical lymph adenopathy.
  • Oral cancers are part of head and neck cancers.
  • Key head and neck regions include lip, tongue, buccal mucosa, gingiva, floor of mouth, roof of the mouth (palate), and cheek lining.
  • Approximately 90-95% of oral cancers are squamous cell carcinomas.
  • Global incidence is estimated at 4 cases per 100,000 people.
  • 180,000 deaths occur annually.
  • Incidence varies by socioeconomic factors; more common in men and older individuals.
  • Human papillomavirus (HPV) infections are a rising cause in North America and Europe, impacting young people.

Epidemiological Methods Learning Outcomes

  • Understanding the epidemiology of oral cancers.
  • Evaluating incidence and prevalence of oral cancers.
  • Identifying oral cancer types and etiological factors.

Cancer Characteristics

  • Cancer is characterized by abnormal cell growth.
  • The ability to invade adjacent tissues and even distant organs.
  • The eventual death of the affected patient if the tumor progresses beyond the treatable stage.

Host Factors of Oral Cancers

  • Age: Incidence increases with age, but age patterns vary by country and risk factors.

  • Gender: Males have higher age-specific incidence rates. This likely stems from higher exposure to risk factors.

  • Race/Ethnicity: Prevalence differs significantly based on cultural factors and behaviors. Whites have higher rates of lip melanoma, while other groups may have higher rates of specific tumors in the areas.

  • Site: Tongue is the most common site globally.

    • Lip: Most common on the lower lip, affecting both sides equally, and affecting mostly older men. Risk factors include tobacco, heavy alcohol use, and prolonged exposure to natural or artificial sunlight.
    • Buccal Mucosa: Inner lining of the cheeks and lips; outer cheek cancer is considered skin cancer. Common causes include tobacco, heavy alcohol, and things like biting cheeks or ill-fitting dental prosthetics.
    • Gingiva: Accounts for less than 10% of oral cancers. It often mimics related benign conditions due to its location to teeth and gum tissue. Chronic irritations, tobacco, and excessive alcohol use are key factors.
    • Palate: A less common site, with around 9% incidence. Common in reverse smokers, pipe users, and those drinking excessive alcohol.
    • Floor of the mouth: accounts for 15% of intraoral cancers. Frequently mistaken for other lesions like aphthous ulcers, and is linked to tobacco use, chewing tobacco, pipes, excessive alcohol.
  • Occupation: Textile and male leather workers show increased risk due to exposure to carcinogenic chemicals.

  • Smoking: A critical etiologic factor. Cigarette smoke contains thousands of chemicals, including 60+ carcinogens.

  • Alcohol Consumption: A significant contributing factor, especially in conjunction with tobacco use.

  • HPV (Human Papillomavirus): Increasingly important in some areas.

  • Chronic Irritations: Ill-fitting dentures or sharp teeth/structures can increase risk.

Tobacco-Induced Diseases and Pathways

  • Tobacco is a major factor in oral cancer development.
  • Nicotine: Is a key part of tobacco's addictive qualities. It triggers dopamine release associating pleasure with use.
  • Tar: Consists of particulate matter during cigarette smoking with chemical components including nitrosamines, polycyclic aromatic hydrocarbons (PAHs), and carbon monoxide (CO).
  • CO: Interacts with hemoglobin, reducing oxygen delivery to tissues.
  • Radioactive compounds, like polonium-210, are found in tobacco and are carcinogens.
  • Nitrosamines: Carcinogenic compounds created by reactions between nitrates, nitrites, and amines. They are found in various foods, tobacco, and alcohol.
  • Infections: The prevalence of oral and head and neck cancers correlate with viruses and certain bacteria.

Agent Factors of Oral Cancers

  • Biological factors: Viruses (HIV, HPV, EBV, HSV), Fungi (Candida).
  • Chemical factors: Arsenic, dyes, nickel, aromatic amines, chromium.
  • Mechanical factors: Sharp teeth or dentures, chronic irritation.
  • Nutritional factors: Precarcinogens in foods, deficiencies in Vitamins, and Protein.

Environmental Factors of Oral Cancers

  • Water Contaminants: Organic pollutants like chloroform.

  • Air Pollution: Gases from vehicles and factories.

  • Solar Heat: Prolonged sun exposure can cause melanoma.

  • Industrialization: Released toxins contaminate water and air.

  • Geographic Variations: Oral cancer incidence rates differ widely. This is often linked to different prevalence of risk factors in particular geographic regions.

Additional Information

  • Oral cancer accounts for over 140,000 deaths and over 300,000 cases each year worldwide.
  • Tobacco, alcohol, and poor diet likely contribute to about 90% of head and neck cancer cases.
  • The predominant forms of tobacco use vary geographically.

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