ABSTRACT
OBJECTIVE: To date, no secondary prevention program is in place for patients carrying an increased risk for developing head and neck cancer (HNSCC). In terms of successful, long-term curative therapy and increased quality of life, it would be useful to detect such diseases at an early stage. PATIENTS AND METHODS: A total of 370 patients with at least one risk factor such as "smoking", "alcohol", or "reflux disease" and without any symptoms were examined during a 1-year period using standard HNO methods (e. g. endoscopy) for suspicious alterations of the mucosa of the upper aerodigestive tract. RESULTS: In 13 (3.5%) of all 370 cases a biopsy was taken for further diagnosis. Squamous cell carcinoma was found in eight cases, while one further patient was suffering from non-Hodgkin lymphoma. CONCLUSIONS: It is simple and safe to examine patients at risk of developing HNSCC by standard HNO methods. The rate of detected carcinomas is much higher than in former investigations, likely because our survey focused only on patients with specific risk factors.
Subject(s)
Head and Neck Neoplasms/epidemiology , Head and Neck Neoplasms/pathology , Mass Screening/statistics & numerical data , Mouth Mucosa/pathology , Otolaryngology/statistics & numerical data , Private Practice/statistics & numerical data , Early Diagnosis , Female , Germany/epidemiology , Humans , Male , Middle Aged , Prevalence , Risk Assessment , Risk FactorsABSTRACT
Within the last decades a considerable amount of epidemologic evidence has been built up to implicate chronic alcohol consumption as a major risk factor not only for oral and pharyngeal cancer, but also for laryngeal cancer. The mechanisms that underlie alcohol-related cancers of the larynx have remained largely unclear. Since the epithelium of the glottic region normally has no direct contact with alcoholic beverages, alcohol-related alterations of glottic mucosa have been questioned. In the present study 20 male Wistar rats were fed nutritionally adequate liquid diets containing 36% of the total calories either as ethanol or isocaloric carbohydrates for 6 months. Morphometric analysis of the glottic mucosa in the ethanol-fed rats showed a significant reduction in epithelial thickness of the glottic epithelium of the anterior commissure as well as of the posterior commissure (P < 0.001). Morphometric analysis of the basal cell nuclei of the glottic epithelium did not show any statistically significant differences between ethanol-fed rats and control rats. These findings indicate that chronic ethanol consumption can cause a significant atrophy of the glottic mucosal epithelium in the rat and suggest an enhanced susceptibility toward locally acting chemical carcinogens.
