Oral cavity cancer in young, non-smoking, and non-drinking patients: A contemporary review

• Published in: Critical reviews in oncology/hematology Vol. 190; p. 104112
• Main Authors: Tran, Quan, Maddineni, Sainiteesh, Arnaud, Ethan Hunter, Divi, Vasu, Megwalu, Uchechukwu C., Topf, Michael C., Sunwoo, John B.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2023
• Subjects: Carcinoma, Squamous Cell; Female; Head and neck cancer; Head and Neck Neoplasms; Humans; Mouth Neoplasms - diagnosis; Mouth Neoplasms - epidemiology; Mouth Neoplasms - etiology; Non-drinkers; Non-smokers; Oral cancer; Squamous Cell Carcinoma of Head and Neck - epidemiology; Squamous Cell Carcinoma of Head and Neck - etiology; Squamous Cell Carcinoma of Head and Neck - therapy; Young; Head and neck cancer; Young; Oral cancer; Non-smokers; Non-drinkers
• ISSN: 1040-8428; 1879-0461; 1879-0461
• DOI: 10.1016/j.critrevonc.2023.104112

Oral squamous cell carcinoma (OSCC) in non-smoking and non-drinking (NSND) individuals appears to be distinct from the traditional head and neck squamous cell carcinoma (HNSCC). The incidence of this subset is increasing, as are the number of studies examining its characteristics. NSND OSCC individuals tend to be younger (<45 years) compared to traditional HNSCC patients. The proportion of females in the NSND OSCC cohort is also higher. The tongue is the predominantly affected subsite. Studies have revealed several gene mutations and unique epigenomic profiles but no definitive genetic etiology. Transcriptomic analysis has not found any causative viral agents. Other proposed etiologies include chronic dental trauma, microbiome abnormalities, marijuana consumption, and genetic disorders. There are international efforts to determine the relative prognostic outcome of this unique cohort, but no consensus has been reached. Here, we review the incidence, demographics, subsite, possible etiologies, prognosis, and therapy implications of the NSND OSCC cohort. [Display omitted] •Incidence of nonsmoking/nondrinking related oral cancer is increasing.•Patients tend to be younger and have more females than traditional cohort.•The etiology of this atypical subset of oral cancers is not known.•Consensus definitions for this emerging subset are needed.