title: Squamous cell carcinoma of the head and neck in nonsmokers and nondrinkers: an analysis of clinicopathologic characteristics and treatment outcomes.
abstract: BACKGROUND
  The objective of this study was to describe the clinicopathologic manifestations of disease and outcomes of treatment among individuals without a history of smoking tobacco or consuming alcohol who develop head and neck cancer.
  
  
  METHODS
  Of 1648 invasive head and neck cancer cases treated between 1970 and 2001 at Roswell Park Cancer Institute, 40 patients were identified as never having smoked tobacco or consumed alcohol during their lifetime. These cases were reviewed to gather data on multiple clinicopathologic variables.
  
  
  RESULTS
  Mean age at presentation of nonsmoker/nondrinker head and neck cancer patients was 60 years (range, 27 to 90 years), and 78% (n = 31) of the patients were women. The distributions of tumor sites were 75.0% oral cavity (n = 30), 20.0% oropharynx (n = 8), and 5.0% larynx (n = 2). Sixteen patients (40%) experienced a recurrence of disease during the follow-up period, and 10 patients (25.0%) developed a second primary tumor a median of 6 years after their initial diagnosis.
  
  
  CONCLUSIONS
  The nonsmoker/nondrinker head and neck cancer patient tends to be elderly and female, have oral cavity primary tumors, and be predisposed to second primary tumor development.
authors.affiliation: Departments of Head and Neck Surgery, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
authors.forename: Sam M
authors.initials: SM
authors.lastname: Wiseman
authors.forename: Helen
authors.initials: H
authors.lastname: Swede
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Stoler
authors.forename: Garth R
authors.initials: GR
authors.lastname: Anderson
authors.forename: Nestor R
authors.initials: NR
authors.lastname: Rigual
authors.forename: Wesley L
authors.initials: WL
authors.lastname: Hicks
authors.forename: Wade G
authors.initials: WG
authors.lastname: Douglas
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Tan
authors.forename: Thom R
authors.initials: TR
authors.lastname: Loree
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking