SANTA BARBARA, CALIF. — Squamous cell carcinoma of the oral cavity, particularly of the tongue, is not a diagnosis seen only in smokers aged 65 and up, reports in the literature suggest.
“We're seeing a surge of cases among younger people,” Dr. Janellen Smith said at the annual meeting of the California Society of Dermatology and Dermatologic Surgery.
Current literature from around the world documents the story: a puzzling rise of oral squamous cell carcinoma (SCC) cases in people as young as their 20s, often in the absence of traditional risk factors such as years of smoking, tobacco chewing, or alcohol use.
Among the young as well as older patients, the tongue is the most common intraoral site for SCC, at 40% of newly diagnosed cases.
Theories abound as to what may be driving this, said Dr. Smith, professor of dermatology at the University of California, Irvine.
Marijuana use, chewing tobacco, and human papillomavirus are all considered potential contributors. It is important to diagnose SCC in its early stages, while it is treatable. The 5-year survival in cases diagnosed late “has not changed in years and years,” and hovers around 50%.
White patches and plaques of leukoplakia are telltale signs. Common early presentations are along the posterolateral border and the ventral surface of the tongue–regions of thin, nonkeratinized mucosa and saliva pooling, said Dr. Smith, who reported no potential conflicts of interest.