Smoking, alcohol consumption and human papillomavirus infection as risk factors for oral cavity and oropharyngeal tumors in Serbia –  A pilot study

Ljiljana Božić; Predrag Jeremić; Milovan Dimitrijević; Tanja Jovanović; Aleksandra Knežević

doi:10.2298/VSP180223143B

Ljiljana Božić Faculty of Medicine, University of Banja Luka
Predrag Jeremić Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia
Milovan Dimitrijević Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia
Tanja Jovanović Institute of microbiology and immunology, Faculty of Medicine, University of Belgrade
Aleksandra Knežević Institute of microbiology and immunology, Faculty of Medicine, University of Belgrade

DOI: https://doi.org/10.2298/VSP180223143B

Keywords: alcohol drinking;, carcinoma, squamous cell;, human papillomavirus;, mouth neoplasms;, pharyngeal neoplasms;, risk factors;, serbia;, smoking

Abstract

Background/Aim. The oral cavity and oropharyngeal cancers are among the most common cancers worldwide with the multifactorial etiology. The aim of this study was to determine the major risk factors among patients with oral cavity and oropharyngeal tumors in Serbia. Methods. A total of 63 patients with biopsy proven malignant (33 patients) or benign (30 patients) oral cavity or oropharyngeal lesions were included in this study. The data about gender, age, smoking habits and alcohol consumption were obtained from the routine medical files. The detection and genotyping of human papillomavirus (HPV) was done in paraffin embedded tissue samples using in situ hybridization. Results. Malignant lesions were more frequent in men, smokers and patients who consume alcohol with a statistically significant difference compared to the patients with benign lesions. The prevalence of HPV infection was higher in patients with malignant lesions compared to patients with benign lesions, but without statistically significant difference. High risk genotypes were detected only in patients with malignant lesions of tonsils and base tongue cancer, while low risk types were demonstrated in patients with benign lesions with a highly statistically significant difference. Conclusion. The results point to the significant association of tobacco smoking, alcohol consumption and high risk HPV genotypes as risk factors for oral cavity and oropharyngeal carcinomas in Serbian patients.

References

Shield KD, Ferlay J, Jemal A, Sankaranarayanan R, Chaturvedi AK, Bray F, et al. The global incidence of lip, oral cavity, and pharyngeal cancers by subsite in 2012. CA Cancer J Clin 2017; 67(1): 51–64.

EUROCAN. Cancer fact sheets. Available from: http://eco.iarc.fr/eucan/cancer.aspx?Cancer=1

Sand L, Jalouli J. Viruses and oral cancer. Is there a link? Mi-crobes Infect 2014; 16(5): 371–8.

Hillbertz NS, Hirsch JM, Jalouli J, Jalouli MM, Sand L. Viral and molecular aspects of oral cancer. Anticancer Res 2012; 32(10): 4201–12.

Scully C, Bagan JV. Recent advances in Oral Oncology. Oral Oncol 2007; 43(2): 107–15.

Bosch FX, Burchell AN, Schiffman M, Giuliano AR, de Sanjose S, Bruni L, et al. Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine 2008; 26 Suppl 10: K1–16.

Majchrzak E, Szybiak B, Wegner A, Pienkowski P, Pazdrowski J, Luczewski L, et al. Oral cavity and oropharyngeal squamous cell carcinoma in young adults: a review of the literature. Ra-diol Oncol 2014; 48(1): 1–10.

Warnakulasuriya S. Global epidemiology of oral and oropha-ryngeal cancer. Oral Oncol 2009; 45(4–5): 309–16.

Chaturvedi AK, Anderson WF, Lortet-Tieulent J, Curado MP, Fer-lay J, Franceschi S, et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. J Clin Oncol 2013; 31(36): 4550–9.

Vlajinac HD, Marinkovic JM, Sipetic SB, Andrejic DM, Adanja BJ, Stosic-Divjak SL. Case-control study of oropharyngeal can-cer. Cancer Detect Prev 2006; 30(2): 152–7.

Kozomara R, Jović N, Magić Z, Branković-Magić M, Minić V. p53 mutations and human papillomavirus infection in oral squa-mous cell carcinomas: correlation with overall survival. J Cra-niomaxillofac Surg 2005; 33(5): 342–8.

Zeljic K, Supic G, Stamenkovic Radak M, Jovic N, Kozomara R, Magic Z. Vitamin D receptor, CYP27B1 and CYP24A1 genes polymorphisms association with oral cancer risk and survival. J Oral Pathol Med 2012; 41(10): 779–87.

Supic G, Kozomara R, Zeljic K, Jovic N, Magic Z. Prognostic value of the DNMTs mRNA expression and genetic polymorphisms on the clinical outcome in oral cancer patients. Clin Oral In-vestig 2017; 21(1): 173–82.

Fang HJ. Risk factors associated with oral and maxillofacial benign tumors: A case-control study. Cell Mol Biol (Noisy-le-grand) 2017; 63(8): 23–6.

Pytynia KB, Dahlstrom KR, Sturgis EM. Epidemiology of HPV-associated oropharyngeal cancer. Oral Oncol 2014; 50(5): 380–6.

Cartwright SJ. A Review of Literature Pertaining to Head and Neck Squamous Cell Carcinoma with Emphasis on the Role of the Human Papilloma Virus. Int J Otorhinolaryngol Head Neck Surg 2014; 3(5): 279–92.

Ramqvist T, Grün N, Dalianis T. Human papillomavirus and tonsillar and base of tongue cancer. Viruses 2015; 7(3): 1332–43.

Walline HM, Komarck C, McHugh JB, Byrd SA, Spector ME, Hauff SJ, et al. High-risk human papillomavirus detection in oropharyngeal, nasopharyngeal, and oral cavity cancers: com-parison of multiple methods. JAMA Otolaryngol Head Neck Surg 2013; 139(12): 1320–7.

Popović B, Jekić B, Novaković I, Luković L, Konstantinović V, Babić M, et al. Cancer genes alterations and HPV infection in oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2010; 39(9): 909–15.

Nordfors C, Vlastos A, Du J, Ahrlund-Richter A, Tertipis N, Grün N, et al. Human papillomavirus prevalence is high in oral samples of patients with tonsillar and base of tongue cancer. Oral Oncol 2014; 50(5): 491–7.

Prabhu SR, Wilson DF. Human papillomavirus and oral disease – emerging evidence: a review. Aust Dent J 2013; 58(1): 2-10; quiz 125.

Marur S, D'Souza G, Westra WH, Forastiere AA. HPV-associated head and neck cancer: a virus-related cancer epi-demic. Lancet Oncol 2010; 11(8): 781–9.

Gillison ML, Chaturvedi AK, Anderson WF, Fakhry C. Epidemi-ology of Human Papillomavirus-Positive Head and Neck Squamous Cell Carcinoma. J Clin Oncol 2015; 33(29): 3235–42.