title: Panoramic radiographs of head and neck cancer patients are often evidence of carotid artery atherosclerotic lesions: a sign of high-risk comorbid illness.
abstract: OBJECTIVE
  The purpose of this study was to estimate the prevalence and identify the risk factors for calcified carotid artery plaque (CCAP) in patients with squamous cell carcinoma of the head and neck.
  
  
  METHODS
  Radiographs of 48 consecutive patients were evaluated for CCAP and their medical histories reviewed for the anatomic extent of cancer (staging) and atherogenic risk factors (age, extent of alcohol and tobacco use, body mass index, hypertension, dyslipidemia, and diabetes mellitus).
  
  
  RESULTS
  Unilateral or bilateral CCAPs were found in 52.1% of subjects (mean age, 61.5 years). Hypertension was seen in a larger percentage (60%; P = .049) of subjects with CCAP on their radiographs compared with those without CCAP (30.4%). No other atheroma risk factors or stage of cancer differed significantly between those with and those without CCAP.
  
  
  CONCLUSIONS
  Panoramic radiographs of patients with squamous cell carcinoma of the head and neck show a very high rate of CCAP, a marker of comorbid vascular diseases that may cause treatment complications and affect overall survival.
authors.affiliation: Graduate Medical Education, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. arthur.friedlander@med.va.gov
authors.forename: Arthur H
authors.initials: AH
authors.lastname: Friedlander
authors.forename: Tracey
authors.initials: T
authors.lastname: Tajima
authors.forename: Neal R
authors.initials: NR
authors.lastname: Garrett
mesh_terms: D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging*; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D015897:Comorbidity; D048909:Diabetes Complications; D005544:Forecasting; D006258:Head and Neck Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D015996:Survival Rate