Oral cancer in Northern Norway (1986-2009)

Abstract

This was a retrospective clinical study looking at those diagnosed with primary oropharyngeal cancer at the University hospital of Northern Norway (UNN) from 1986-2002 (follow up to 2009) and various factors’ influence on patient survival. In this period 162 persons were diagnosed with primary cancer in the oral cavity, patients with metastasis to the oral cavity were not included. Information about age, gender, time of diagnosis, smoking habits, alcohol consumption, TNM grading and differentiation of the primary tumor, treatment regiments and whether or not the disease had recurred were collected from the hospital journals. Information on cause of death was retrieved from the Norwegian institute of Public Health after application. Descriptive and survival statistical analyses were performed, and the results were compared with national data from the Norwegian Cancer Registry as well as with results from international studies. Calculation of incidence showed that there was an increasing incidence of head and neck squamous cell carcinomas (HNSCC) in the Northern Norwegian population from 1994-2002, most notably of tongue SCCs. Distribution of male and female were 56 % and 44 % respectively, and 62 % of the patients were ≥60years at the time of diagnosis. The majority of the tumors were either well (32 %) or moderately (64 %) differentiated. Sixty-three percent of the tumors were diagnosed at T-stage 1 or 2, meaning that they were rather small, whereas 28 % were diagnosed at T-stage 3 or 4. Fifty-four percent of the patients had no metastatic disease at time of diagnosis (N0, M0). Gender stratification showed that a higher proportion of females than males were diagnosed before the onset of metastases (~60 % and ~50 % respectively). In the study population 45 % were smokers and 19 % reported that they consumed alcohol more than once a week. We found that high alcohol consumption had a significant negative influence on survival. Smokers also showed a lower 5-years survival rate than non-smokers, but the differences were not statistically significant. Women showed significantly better 5-year survival rate than men with the same TNM-staging.