University Hospital for Tumors, University Hospital Center Sestre milosrdnice
Abstract
Introduction: It was expected at least in Western countries that incidence of head and neck cancers (HNSCC) should become lower due to the propaganda against smoking. However, the expected decrease in HNSCC was not achieved in many countries. Tobacco and alcohol consumption are known as a major risk factors for development of HNSCC. It is well known that 15-20% of HNSCC are linked to HPV infection, however, some authors reported coexistence with other viruses as well. In the Eastern countries paan (betel nut), ghutka, that have been also linked to the development HNSCC. However, lately HNSCC have been linked to the low vegetable and fruit intake, vitamin defi ciencies, coinfection with other viruses, certain genetic syndromes and occupational exposure. Therefore, the aim of this study is to review recent literature regarding epidemiology and other risk factors in the development of HNSCC.
Methods: Pubmed was searched in the past two years in order to fi nd out novelties regarding epidemiology and aetiology for HNSCC and 34 papers were included.
Results and Conclusion: The results of this review paper show that smoking is a major contributing factor especially with alcohol both being dosed and time dependent in the development of HNSCC. Unhealthy diet, decrease in vitamin intake especially folate, C and E vitamin and occupational exposure were seen in the diseased. In about one fourth of the patients infection with HPV has been noticed, and in some coinfection with other viruses such as Epstein Barr, cytomegalovirus
and HIV. Obviously genetic predisposition exists but also correlation with certain genetic syndromes such as Fanconi’s anaemia and Bloom syndrome.Uvod: Očekivalo se barem u Zapadnim zemljama kako će incidencija karcinoma glave i vrata biti manja uslijed propagande protiv pušenja. Ipak, očekivano smanjenje u incidenciji karcinoma glave i vrata nije postignuto u mnogim zemljama. Pušenje i konzumacija alkohola su glavni faktori rizika za nastanak karcinoma glave i vrata. Dobro je poznato da je 15-20% karcinoma glave i vrata povezao s HPV infekcijom, doduše, neki autori su izvijestili i o koegzistenciji s drugim virusima također. U istočnim zemljama paan (betel nut), ghutka su također povezani s nastankom carcinoma glave i vrata. Ipak,
nedavno je karcinom glave i vrata povezan s rijetkim unosom povrća i voća, defi citom vitamina, koinfekcijom s drugim virusima, određenim genetskim sindromima i radnim okolišem. Stoga je cilj ovog istraživanja bio pregledati noviju literature s obzirom na epidemiologiju i druge rizične faktore u nastanku karcinoma glave i vrata.
Metode: Pubmed je pretražen u zadnje dvije godine kako bi se ustanovilo novosti vezane uz epidemiologiju i etiologiju karcinoma glave i vrata te su 34 rada uključena.
Rezultati i zaključci: Rezultati ovog preglednog rada pokazuju kako je pušenje najvažniji faktor koji doprinosi nastanku karcinoma glave i vrata uz konzumiranje alkohola, a što ovisi o dozi i vremenu izloženosti. Nezdrava prehrana,smanjeni unos vitamina, posebice folata, C i E vitamina i radni okoliš se ustanove u oboljelih. U oko četvrtine pacijenata je ustanovljena infekcija s HPV virusom, a u nekih i koinfekcija s drugim virusima poput Epstein Barrovog, citomegalovirusa
i HIV-a. Očito genetska predispozicija postoji ali i korelacija sa određenim genetskim sindromima poput Fankonijeve anemije
i Bloomovog sindroma
