The increase was primarily limited to white Americans, and the reason for the rise is unclear.
"It's been known since the mid-1980s that there has been an increase in oral and tongue cancers among young adults," says Dr. Stimson Schantz, the Paul L. Chodosh professor of Otolaryngology at New York Medical College's Eye and Ear Infirmary in New York City."What we wanted to do was look more closely at the National Cancer Institute's Surveillance, Epidemiology and End Results program because the registry, established in the early '70s, has data that is now more complete and more extensive," Schantz says.
Schantz's review found 63,409 cases of head and neck cancers among Americans from 1973 to 1987, 3,339 among people under 40. Most were tongue cancers.
"The oral tongue cancer rates in whites younger than age 40 began in people born in the mid-1940s. The questions is, as the population ages, will the disease increase? Our concern is that it will increase," he says.
Schantz's findings were presented May 12 at the spring meeting of the American Head and Neck Society in Palm Desert, Calif.
Approximately 6,700 new cases of tongue cancer occur every year, says the American Cancer Society, and the disease kills about 1,700 people annually. Tongue cancer is more common in people who smoke cigarettes, pipes or chew tobacco.
But the news isn't all bad.
"Even though the disease is increasing, it seems to be less aggressive, and the survival rates are better," Schantz says. "Treatment usually consists of surgery and radiation, and while the cancer can spread, there is a relatively low instance of metastasis."
Nobody's sure what's causing the increase, Schantz says. "There is some consideration that it might be socioeconomic because it's not seen in black males," he says. "And marijuana use may be a risk factor. But it is very speculative as to what the [cause] is."
Dr. Jatin Shah, chairman of Memorial Sloan Kettering Cancer Center's department of head and neck surgery in New York City, says Schantz's findings "corroborate the impression we surgeons had of the increasing incidence of tongue cancer in young Americans."
Shah calls the trend a "good-news, bad-news situation."
"The bad news is that the high incidence has been persistent over the past 15 years in young, white Americans. The good news is that the disease presents at an early stage and consequently the cure rates have been improved," he says.
"In many situations, surgery alone is enough," Shah says. "Part of the tongue is removed and sufficient tissue is left behind for speech and chewing. However, in those individuals who require removal of a major part of the tongue, there are reconstructive techniques available utilizing micro-surgery to rebuild the tongue."
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