title: Squamous cell carcinoma of the oral cavity in patients aged 45 years and under: a descriptive analysis of 116 cases diagnosed in the South East of England from 1990 to 1997.
abstract: BACKGROUND
  there is, currently, much anecdotal and some epidemiological evidence for a rise in oral cancer rates amongst younger individuals, many of whom have had no exposure to traditional risk factors such as tobacco and heavy alcohol use, or at least not the exposure over decades usually associated with this disease. The probity of this assertion and the presence or absence of traditional risk factors needs further evidence.
  
  
  OBJECTIVE
  this paper describes the demography and the exposure to potential risk factors amongst a cohort aged 45 years and younger, diagnosed with squamous cell carcinoma of the oral cavity between 1990 and 1997 from the South East of England.
  
  
  METHODS
  eligible patients registered with a cancer registry were included in this retrospective study. Information was accessed from the database and by a postal questionnaire survey. The self-completed questionnaire contained items about exposure to the following risk factors: tobacco; alcohol; diet; frequency of dental visits and familial cancer.
  
  
  CONCLUSIONS
  this is the largest UK epidemiological study so far to be undertaken on young subjects diagnosed with oral cancer. One-hundred and sixteen cases were recruited representing a response rate of 59%. Slightly over 90% of this cohort were classified as white European. A large proportion of cases (40%) were from social classes I & II suggesting either a true social class difference in young cases versus older oral cancer cases or a possible bias in responders or survivors. Risk factors of tobacco use and excessive alcohol consumption were present in the majority (75%) of patients. Significant differences in the pattern of alcohol consumption were found in female subjects, who were less likely to consume over the recommended amounts of alcohol compared with male subjects. Daily regular fresh fruit and vegetable consumption during the ten year period before cancer diagnosis was recorded to be low. There was a distinct subgroup of cases, 26% of the group, that showed little, if any, exposure to any major risk factors.
authors.affiliation: Department of Oral Medicine and Pathology, Guy's, King's and St Thomas' School of Dentistry, King's College London, Denmark Hill Campus, Caldecot Road, London SE5 9RW, UK.
authors.forename: C D
authors.initials: CD
authors.lastname: Llewellyn
authors.forename: K
authors.initials: K
authors.lastname: Linklater
authors.forename: J
authors.initials: J
authors.lastname: Bell
authors.forename: N W
authors.initials: NW
authors.lastname: Johnson
authors.forename: K A A S
authors.initials: KA
authors.lastname: Warnakulasuriya
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology*; D003729:Dental Care / Q000706:statistics & numerical data; D004032:Diet / Q000009:adverse effects; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012923:Social Class