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Cancer Causes & Control

, Volume 11, Issue 6, pp 489–495 | Cite as

Changing patterns of tonsillar squamous cell carcinoma in the United States

  • Morten Frisch
  • Henrik Hjalgrim
  • Ane Bonnerup Jæger
  • Robert J. Biggar
Article

Abstract

Objective: Tonsillar squamous cell carcinoma (SCC) may differ etiologically from other oral cancers. The aim of this study was to provide a detailed description of the incidence patterns of tonsillar SCC in the United States.

Methods: Population-based incidence data from the Connecticut Tumor Registry (period 1945–1994) and from the SEER program (period 1973–1995) were used to calculate age-standardized (US 1970) and age-specific incidence rates and confidence intervals (CIs). Linear regression was used to evaluate trends.

Results: The incidence of tonsillar SCC increased fourfold among white women in Connecticut during 1945–1994 but remained rather constant in white men. During 1973–1995, incidence rates per million person-years were considerably higher in blacks (31.6; 95% CI: 29.0–34.4 in men, and 9.6; 95% CI: 8.3–10.9 in women) than whites (14.8; 95% CI: 14.3–15.3 in men, and 6.1; 95% CI: 5.8–6.4 in women). Men, but not women, who were younger than 60 years experienced significant annual increases in tonsillar SCC incidence during 1973–1995 (2.7% in blacks and 1.9% in whites). No similar increases occurred for oral SCC at non-tonsillar sites.

Conclusion: Incidence rates of tonsillar SCC vary considerably by sex, race and time in a way that cannot be explained by changes in tonsillectomy practices alone. Changes in environmental risk factors, including changes in smoking patterns and an increase in oral human papillomavirus infections, may have contributed.

human papillomaviruses oral neoplasms tobacco smoking tonsillar neoplasms tonsillectomy 

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References

  1. 1.
    Morse DE, Pendrys DG, Neely AL, et al. (1999) Trends in the incidence of lip, oral, and pharyngeal cancer: Connecticut, 1935-94. Oral Oncol 35: 1–8.Google Scholar
  2. 2.
    Møller H (1989) Changing incidence of cancer of the tongue, oral cavity, and pharynx in Denmark. J Oral Pathol Med 18: 224–229.Google Scholar
  3. 3.
    Ostman J, Anneroth G, Gustafsson H, et al. (1995) Malignant oral tumours in Sweden 1960-89-an epidemiological study. Eur J Cancer B Oral Oncol 31B: 106–112.Google Scholar
  4. 4.
    Plesko I, MacFarlane GJ, Evstifeeva TV, et al. (1994) Oral and pharyngeal cancer incidence in Slovakia 1968-1989. Int J Cancer 56: 481–486.Google Scholar
  5. 5.
    Swango PA (1996) Cancers of the oral cavity and pharynx in the United States: an epidemiologic overview. J Public Health Dent 56: 309–318.Google Scholar
  6. 6.
    Paz IB, Cook N, Odom-Maryon T, et al. (1997) Human papillomavirus (HPV) in head and neck cancer. An association of HPV 16 with squamous cell carcinoma of Waldeyer's tonsillar ring. Cancer 79: 595–604.Google Scholar
  7. 7.
    Gillison ML, Koch WM, Shah KV (1999) Human papillomavirus in head and neck squamous cell carcinoma: are some head and neck cancers a sexually transmitted disease? Curr Opin Oncol 11: 191–199.Google Scholar
  8. 8.
    Frisch M, Biggar RJ (1999) Aetiological parallel between tonsillar and anogenital squamous-cell carcinomas. Lancet 354: 1442–1443.Google Scholar
  9. 9.
    Flannery JT, Boice JD, Devesa SS, et al. (1985) Cancer registration in Connecticut and the study of multiple primary cancers, 1935-82. Natl Cancer Inst Monogr 68: 13–24.Google Scholar
  10. 10.
    Young JL Jr, Percy CL, Asire AJ, eds (1981) Surveillance, Epidemiology, and End Results: Incidence and Mortality Data, 1973-77. NIH Publication No. 81-2330 Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Cancer Institute.Google Scholar
  11. 11.
    Percy C, van Holten V, Muir C, eds (1990) International Classification of Diseases for Oncology, 2nd edn. Geneva: World Health Organization.Google Scholar
  12. 12.
    Freeman JL, Jekel JF, Freeman DH Jr (1982) Changes in age and sex specific tonsillectomy rates: United States, 1970-1977. Am J Public Health 72: 488–491.Google Scholar
  13. 13.
    Derkay CS (1993) Pediatric otolaryngology procedures in the United States: 1977-1987. Int J Pediatr Otorhinolaryngol 25: 1–12.Google Scholar
  14. 14.
    Anonymous (1993) Tonsillectomy and adenoidectomy in-hospital charges, 1991. Stat Bull Metrop Insur Co. 74: 20–28.Google Scholar
  15. 15.
    Blot WJ, McLaughlin JK, Devesa SS, et al. (1996) Cancers of the oral cavity and pharynx. In: Schottenfeld D, Fraumeni JF Jr, eds. Cancer Epidemiology and Prevention, 2nd edn., New York: Oxford University Press, pp. 666–680.Google Scholar
  16. 16.
    Baron JA, Rohan TE (1996) Tobacco. In: Schottenfeld D, Fraumeni JF Jr, eds. Cancer Epidemiology and Prevention, 2nd edn., New York: Oxford University Press, pp. 269–289.Google Scholar
  17. 17.
    Syrjanen SM, Syrjanen KJ, Happonen R-P (1988) Human papillomavirus (HPV) DNA sequences in oral precancerous lesions and squamous cell carcinoma demonstrated by in situ hybridization. J Oral Pathol 17: 273–278.Google Scholar
  18. 18.
    Brandsma JL, Abramson AL (1989) Association of papillomavirus with cancers of the head and neck. Arch Otolaryngol Head Neck Surg 115: 621–625.Google Scholar
  19. 19.
    Niedobitek G, Pittero. S, Herbst H, et al. (1990) Detection of human papillomavirus type 16 DNA in carcinomas of the palatine tonsil. J Clin Pathol 43: 918–921.Google Scholar
  20. 20.
    Brachman DG, Graves D, Vokes E, et al. (1992) Occurrence of p53 gene deletions and human papilloma virus infection in human head and neck cancer. Cancer Res 52: 4832–4836.Google Scholar
  21. 21.
    Fouret P, Martin F, Flahault A, et al. (1995) Human papillomavirus infection in the malignant and premalignant head and neck epithelium. Diagn Mol Pathol 4: 122–127.Google Scholar
  22. 22.
    Portugal LG, Goldenberg JD, Wenig BL, et al. (1997) Human papillomavirus expression and p53 gene mutations in squamous cell carcinoma. Arch Otolaryngol Head Neck Surg 123: 1230–1234.Google Scholar
  23. 23.
    Andl T, Kahn T, Pfuhl A, et al. (1998) Etiological involvement of oncogenic human papillomavirus in tonsillar squamous cell carcinomas lacking retinoblastoma cell cycle control. Cancer Res 58: 5–13.Google Scholar
  24. 24.
    Schwartz SM, Daling JR, Doody DR, et al. (1998) Oral cancer risk in relation to sexual history and evidence of human papillomavirus infection. J Natl Cancer Inst 90: 1626–1636.Google Scholar
  25. 25.
    Snijders PJF, Steenbergen RDM, Top B, et al. (1994) Analysis of p53 status in tonsillar carcinomas associated with human papillomavirus. J Gen Virol 75: 2769–2775.Google Scholar
  26. 26.
    Wilczynski SP, Lin BT, Xie Y, et al. (1998) Detection of human papillomavirus DNA and oncoprotein overexpression are associated with distinct morphological patterns of tonsillar squamous cell carcinoma. Am J Pathol 152: 145–156.Google Scholar
  27. 27.
    Shopland DR, Hartman AM, Gibson JT, et al. (1996) Cigarette smoking among US adults by state and region: estimates from the current population survey. J Natl Cancer Inst 88: 1748–1758.Google Scholar
  28. 28.
    Blohme I, Brynger H (1985) Malignant disease in renal transplant patients. Transplantation 39: 23–25.Google Scholar
  29. 29.
    Penn I (1986) Cancers of the anogenital region in renal transplant recipients. Cancer 58: 611–616.Google Scholar
  30. 30.
    Melbye M, Cote TR, Kessler L, et al. (1994) High incidence of anal cancer among AIDS patients. Lancet 343: 636–639.Google Scholar
  31. 31.
    Swoboda A, Fabrizii V (1993) Tonsillar carcinoma in a renal graft recipient treated with cyclosporine A. Clin Nephrol 39: 272–274.Google Scholar
  32. 32.
    Gummert JF, Falk V, Walther T, et al. (1995) Tonsillar carcinoma in the early postoperative course following heart transplantation. Thorac Cardiovasc Surg 43: 355–357.Google Scholar
  33. 33.
    Waldron I, Lye D (1989) Family roles and smoking. Am J Prev Med 5: 136–141.Google Scholar
  34. 34.
    Dawson DA, Grant BF, Chou SP, et al. (1995) Subgroup variation in US drinking patterns: results of the 1992 national longitudinal alcohol epidemiologic study. J Subst Abuse 7: 331–344.Google Scholar
  35. 35.
    Jæger AB, Gramkow A, Sørensen P, et al. (2000) Correlates of heterosexual behavior among 23-87 year old persons in Denmark and Sweden, 1992-1998. Arch Sex Behav (In press).Google Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Morten Frisch
    • 1
    • 2
  • Henrik Hjalgrim
    • 2
  • Ane Bonnerup Jæger
    • 2
  • Robert J. Biggar
    • 1
  1. 1.Viral Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaUSA
  2. 2.Department of Epidemiology Research, Danish Epidemiology Science CenterStatens Serum InstitutCopenhagen SDenmark

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