Carcinoma of the tongue: a case-control study on etiologic factors and dental trauma.
BACKGROUND
Carcinoma of the tongue is the most common intra-oral malignancy in Western countries. Incidence and mortality rates have increased in recent years, and survival has not improved. This study aimed to determine etiologic factors for tongue cancer with age-sex matched case-control data.


METHODS
47 patients with carcinoma of the tongue referred to our oral medicine clinic between years 2005-2006 were analyzed and compared with control group data. The medical records , including family history of cancer, dental trauma, and history of abuse of alcohol and tobacco products was recorded for all subjects. Chi square comparison tests and linear regression analysis were performed using the SPSS program for statistics.


RESULTS
Patient and randomly selected control groups each consisted of 30 male and 17 female subjects with mean ages 53.2 (± 12.6) and 52.6 (± 11.5) years respectively. Smoking and alcohol abuse proportions were significantly higher in the patient group (p=0.0001, p<0.0001 respectively). Chronic mechanical trauma was observed in 44.7% of the patients and 17.0% of the control group (p=0.004). Similarly, family history of cancer of any type (for the first degree relatives) was found to be more common in the patient group (p=0.009). On regression analysis, alcohol abuse, family history of cancer, smoking, chronic mechanical traumas appeared as significant etiologic factors (p=0.0001).


CONCLUSIONS
We believe that field cancerization may become evident in oral and oropharyngeal mucosa with multiple steps of molecular changes starting from the first sign of dysplasia with chronic exposure to etiological factors. Chronic trauma cases need particular attention to search for very early signs of cancer.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey E-mail : bektaskk@istanbul.edu.tr.
Kivanc
K
Bektas-Kayhan
Gizem
G
Karagoz
Mustafa Caner
MC
Kesimli
Ahmet Nafiz
AN
Karadeniz
Rasim
R
Meral
Musa
M
Altun
Meral
M
Unur
D000428:Alcohol Drinking / Q000009:adverse effects; D002277:Carcinoma / Q000209:etiology* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000209:etiology* / Q000473:pathology; D009061:Mouth Mucosa / Q000473:pathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014062:Tongue Neoplasms / Q000209:etiology* / Q000473:pathology