Oral Cavity SCC in Young Adults Is on the 'Surge'

SANTA BARBARA, CALIF. — Squamous cell carcinoma of the oral cavity, particularly of the tongue, is not a diagnosis seen only in smokers aged 65 and older, reports in the literature suggest.

"We're seeing a surge of cases among younger people," Dr. Janellen Smith said at the annual meeting of the California Society of Dermatology and Dermatologic Surgery.

Current literature from around the world documents the story: a puzzling rise of oral squamous cell carcinoma (SCC) cases in people as young as their 20s, often in the absence of traditional risk factors such as years of smoking, tobacco chewing, or alcohol use.

Among the young as well as older patients, the tongue is the most common intraoral site for SCC, at 40% of newly diagnosed cases.

Theories abound as to what may be driving this increase of cancer cases, said Dr. Smith, professor of dermatology at the University of California, Irvine.

Marijuana use, chewing tobacco, and human papillomavirus are all considered potential contributors.

Factors predicting prognosis include stage of the cancer, tumor location, and whether the cancer has spread.

It is important is to diagnose SCC in its early stages, while it is treatable. The 5-year survival in cases diagnosed late "has not changed in years and years," and hovers around 50%. "As dermatologists, we are in a position to diagnose this early," she said.

"We know this is not lichen planus," she added, describing the rosy red macules and plaques of erythroplakia, a sign of SCC.

White patches and plaques of leukoplakia are other telltale signs.

Common early presentations are along the posterolateral border and the ventral surface of the tongue—regions of thin, nonkeratinized mucosa and saliva pooling, she said.

Studies show that such SCCs frequently drain to cervical nodes, 66% of which are positive at the time of diagnosis.

Although the precise cause of an uptick in cases is unknown, the theoretical involvement of HPV makes vaccination of young women all the more sensible, Dr. Smith said at a second lecture during a seminar held in Las Vegas and sponsored by Skin Disease Education Foundation.

"We are actually quite anxious to see that people get vaccinated," she said.

Dr. Smith reported no potential conflicts of interest regarding her lectures.

SDEF and this newspaper are owned by Elsevier.

SANTA BARBARA, CALIF. — Squamous cell carcinoma of the oral cavity, particularly of the tongue, is not a diagnosis seen only in smokers aged 65 and older, reports in the literature suggest.

"We're seeing a surge of cases among younger people," Dr. Janellen Smith said at the annual meeting of the California Society of Dermatology and Dermatologic Surgery.

Current literature from around the world documents the story: a puzzling rise of oral squamous cell carcinoma (SCC) cases in people as young as their 20s, often in the absence of traditional risk factors such as years of smoking, tobacco chewing, or alcohol use.

Among the young as well as older patients, the tongue is the most common intraoral site for SCC, at 40% of newly diagnosed cases.

Theories abound as to what may be driving this increase of cancer cases, said Dr. Smith, professor of dermatology at the University of California, Irvine.

Marijuana use, chewing tobacco, and human papillomavirus are all considered potential contributors.

Factors predicting prognosis include stage of the cancer, tumor location, and whether the cancer has spread.

It is important is to diagnose SCC in its early stages, while it is treatable. The 5-year survival in cases diagnosed late "has not changed in years and years," and hovers around 50%. "As dermatologists, we are in a position to diagnose this early," she said.

"We know this is not lichen planus," she added, describing the rosy red macules and plaques of erythroplakia, a sign of SCC.

White patches and plaques of leukoplakia are other telltale signs.

Common early presentations are along the posterolateral border and the ventral surface of the tongue—regions of thin, nonkeratinized mucosa and saliva pooling, she said.

Studies show that such SCCs frequently drain to cervical nodes, 66% of which are positive at the time of diagnosis.

Although the precise cause of an uptick in cases is unknown, the theoretical involvement of HPV makes vaccination of young women all the more sensible, Dr. Smith said at a second lecture during a seminar held in Las Vegas and sponsored by Skin Disease Education Foundation.

"We are actually quite anxious to see that people get vaccinated," she said.

Dr. Smith reported no potential conflicts of interest regarding her lectures.

SDEF and this newspaper are owned by Elsevier.

SANTA BARBARA, CALIF. — Squamous cell carcinoma of the oral cavity, particularly of the tongue, is not a diagnosis seen only in smokers aged 65 and older, reports in the literature suggest.

"We're seeing a surge of cases among younger people," Dr. Janellen Smith said at the annual meeting of the California Society of Dermatology and Dermatologic Surgery.

Current literature from around the world documents the story: a puzzling rise of oral squamous cell carcinoma (SCC) cases in people as young as their 20s, often in the absence of traditional risk factors such as years of smoking, tobacco chewing, or alcohol use.

Among the young as well as older patients, the tongue is the most common intraoral site for SCC, at 40% of newly diagnosed cases.

Theories abound as to what may be driving this increase of cancer cases, said Dr. Smith, professor of dermatology at the University of California, Irvine.

Marijuana use, chewing tobacco, and human papillomavirus are all considered potential contributors.

Factors predicting prognosis include stage of the cancer, tumor location, and whether the cancer has spread.

It is important is to diagnose SCC in its early stages, while it is treatable. The 5-year survival in cases diagnosed late "has not changed in years and years," and hovers around 50%. "As dermatologists, we are in a position to diagnose this early," she said.

"We know this is not lichen planus," she added, describing the rosy red macules and plaques of erythroplakia, a sign of SCC.

White patches and plaques of leukoplakia are other telltale signs.

Common early presentations are along the posterolateral border and the ventral surface of the tongue—regions of thin, nonkeratinized mucosa and saliva pooling, she said.

Studies show that such SCCs frequently drain to cervical nodes, 66% of which are positive at the time of diagnosis.

Although the precise cause of an uptick in cases is unknown, the theoretical involvement of HPV makes vaccination of young women all the more sensible, Dr. Smith said at a second lecture during a seminar held in Las Vegas and sponsored by Skin Disease Education Foundation.

"We are actually quite anxious to see that people get vaccinated," she said.

Dr. Smith reported no potential conflicts of interest regarding her lectures.

SDEF and this newspaper are owned by Elsevier.