ABSTRACT
OBJECTIVES: The high incidence of head and neck cancer (HNC), significantly associated with living environment and behaviour, can be prevented more efficiently. The aim of this study was to evaluate the environmental and behavioural risk factors for HNC. METHODS: Using a detailed questionnaire on social status, education, living and occupational environment exposures, family cancer and lifestyle, HNC patients (103 cases, 76.7% of men) were compared with control subjects (244 subjects, 73% of men) balanced by age: mean (standard deviation) 63.8 (9.3) and 63.8 (9.0) for cases and controls, respectively. RESULTS: The results of this study showed that smoking and low education were significant risk factors for HNC regardless of sex. Family HNC and breast cancer were significant predictors of HNC risk. CONCLUSION: The study confirmed previous results that smoking and low education are significantly associated with HNC. Additionally, results pointed to significant HNC and breast cancer risk in HNC patient's families that may have originated from passive smoking or a smoking habit stemming from social environments that support it. Better dissemination programmes regarding smoking risks for children and adults are needed, targeting not only individuals but also families.
Subject(s)
Alcohol Drinking/epidemiology , Genetic Predisposition to Disease , Head and Neck Neoplasms/epidemiology , Health Behavior , Smoking/epidemiology , Tobacco Smoke Pollution , Adult , Age Factors , Case-Control Studies , Child , Female , Head and Neck Neoplasms/etiology , Head and Neck Neoplasms/genetics , Humans , Incidence , Male , Risk Factors , Sex Factors , Social Determinants of Health , Surveys and QuestionnairesABSTRACT
OBJECTIVE: A series of patients with head and neck adenoid cystic carcinoma (ACC) was studied with respect to treatment modalities, recurrence, survival and prognostic factors. STUDY DESIGN: Between August 1984 and December 2013, 45 patients with ACC of the head and neck who were primary surgically treated at our institution were retrospectively reviewed. RESULTS: Disease-specific survival (DSS) rates at 5, 10, and 15 years were 85%, 79.4%, and 65.7%, respectively. Tumors of the major salivary glands had a better DSS. Patients with ACC of the paranasal sinuses or nasal cavity had poorer survival compared with other head and neck subsites, although this correlation did not reach statistically significant level. DSS rates were 81.5% at 5 years, 70.5% at 10 years, and 31.3% at 15 years for patients with perineural invasion (PNI) compared with 88.9% for those patients who did not have PNI (P = .01). Follow-up ranged from 7 to 337 months (mean 129.4 months). CONCLUSIONS: ACC is a unique malignant salivary gland tumor associated with prolonged survival even in metastatic settings, which emphasizes the necessity for lifetime follow-up as well as more active oncologic treatment. In our study, survival was adversely affected by the primary tumor site and PNI.