Head and Neck Squamous Cell Carcinoma in Iranian Patients and Risk Factors in Young Adults: a Fifteen-Year Study

Background: Head and neck squamous cell carcinoma (HNSCC) is the 8th most common cancer worldwide.Although older age, male gender, smoking and alcohol consumption are known risk factors, an increasingnumber of HNSCC patients are without typical risk factors. Our aim was to define demographics of HNSCCin Iran and the potential risk factors related to Iranian ethnicity and lifestyle.
Methods: We conducted a crosssectionalanalytical study on 262 patients with primary SCC of the larynx, hypopharynx or tongue referred toour pathology department during 1995-2010. Patients’ demographics, tumor characteristics and risk factorssuch as smoking, alcohol consumption and anemia were analyzed and compared in two groups of patients:over 40 years (older group) and 40 years or less (young group); Chi-square and Mann-Whitney analytical testswere employed.
Results: 5.7% of patients were young adults. The male to female ratio was 1.5 in the youngergroup and 5.6 in the older group. In young adults, 40% of tumors were located in larynx and 40% in the tongue.Age >40 was significantly associated with laryngeal location (P<0.001). History of smoking and drinking wassignificantly associated with age >40 and SCC of larynx in both age groups. Cervical lymph node involvementwas significantly correlated with SCC of tongue (P<0.001), however, considering young adults only, SCC ofhypopharynx was most frequently accompanied by lymph node involvement (60%). The most prevalent tumoramong men was SCC of larynx whereas SCC of hypopharynx was the most prevalent tumor among women(61%), of whom 18.2% were ≤40.
Conclusions: The incidence of HNSCC among young adults seems to be higherin Iran compared to other countries. Reduction in exposure to known risk factors, especially tobacco smokingin forms of cigarettes and bubble pipes, and search for other causative agents of HNSCC in young populationis recommended.