@article{d8f1dd2e5acc4a14af7e096d87dd7379,
title = "Impact of varying anatomic sites on advanced stage and survival of oral cancer: 9-year prospective cohort of 27 717 cases",
abstract = "Background: To elucidate the impact of varying anatomic sites on advanced stage of and death from oral cancer. Methods: A total of 27 717 oral cancers mainly from a population-based visual inspection program in Taiwan from 2004 to 2009 was followed until the end of 2012. Results: Using lip cancer as reference, the odds ratios (95% confidence interval [CI]) of advanced stage of cancer were 2.20 (1.92-2.51) for tongue, 2.60 (2.28-2.97) for buccal, 2.68 (2.20-3.28) for floor of mouth, 2.96 (2.52-3.47) for hard palate, 6.04 (5.17-7.05) for gingiva, and 10.83 (9.20-12.74) for oropharynx. The estimated hazard ratios (95% CI) for oral cancer death increased from 1.48 (1.31-1.67) in buccal, 1.61 (1.43-1.82) in tongue, 1.68 (1.41-1.99) in floor of mouth, 1.79 (1.57-2.05) in gingiva, 1.97 (1.71-2.26) in hard palate, and 2.15 (1.89-2.45) in oropharynx. Conclusion: Different anatomic sites had variations in advanced stage of and death from oral cancer and need vigilant surveillance.",
keywords = "anatomic site, betel quid chewing, cigarette smoking, mortality, oral cancer",
author = "Su, {William Wang Yu} and Su, {Chiu Wen} and Chang, {Dun Cheng} and Chuang, {Shu Lin} and Chen, {Sam Li Sheng} and Hsu, {Chen Yang} and Yen, {Amy Ming Fang} and Chiu, {Sherry Yueh Hsia} and Fann, {Jean Ching Yuan} and Lee, {Yi Huah} and Jeng, {Ya Chung} and Lee, {Yi Chia} and Chiu, {Han Mo} and Chen, {Tony Hsiu Hsi} and Wang, {Cheng Ping} and Chen, {Mu Kuan}",
note = "Funding Information: Ministry of Science and Technology, Grant/Award Number: MOST 106-2118-M-002-006-MY2; National Taiwan University Hospital, Grant/Award Number: 201609007W; Health Promotion Administration, Ministry of Health and Welfare, Grant/Award Numbers: A1041122, A1031135, A1021227, A1011119 Funding Information: Our study subjects used for investigating anatomic sites in association with death from oral cancer were composed of all oral cancers identified from Taiwanese residents aged 18 years or older between 2004 and 2009 that was further classified into two groups, the screened and nonscreened population. The former was based on the Taiwanese Nationwide Oral Cancer Screening Program that was launched by the Health Promotion Administration of the Ministry of Health and Welfare of Taiwan, targeting at subjects aged 18 years or older with oral habits of cigarette smoking and/or betel quid chewing. Given a 55.1% screening rate, the total screened population covered 2 334 299 residents between 2004 and 2009. This service screening aims at early detection of oral cancers given the high incidence and mortality of oral cancer in Taiwan. Face-to-face interview by public health workers or medical personnel was performed in the community to collect information on oral habits first, and then the eligible subjects were invited to participate. Subjects who had prior history of oral cancer were excluded from enrollment. The screening was performed by dentists, otolaryngologist, or trained physicians with visual inspection of the oral cavity, including lips, gingivae, buccal mucosa, tongue, floor of mouth, soft and hard palate, uvula, tonsils, and lateral and posterior oropharyngeal walls. Disposable wooden tongue depressor and proper illumination were also used to facilitate the visual inspection. Participants with no visible oral lesions were suggested to be screened biennially. Participants with visible oral lesions, including leukoplakia, erythroplakia, oral submucous fibrosis or suspected malignancy were referred to specialists in the hospital for confirmatory diagnosis and pathological examination. In cases of pathologic diagnosed malignancy, staging workup and further treatment was undertaken and reimbursed by National Health Insurance System, which had a coverage rate of more than 99% of the population in Taiwan. We also enrolled oral cancers identified from the rest of 1 900 094 nonparticipants who were of the same age in the contemporaneous period of the screened group and underwent the identical procedure of oral cancer diagnosis workup as arranged for the screen-detected cases when they had sought to medical care due to the presence of clinical symptoms and signs in the hospital. This study was approved by Health Promotion Administration of the Ministry of Health and Welfare of Taiwan prior to data retrieval, yet the government authorities had no role in the study design, data collection, results analysis, and interpretation. Publisher Copyright: {\textcopyright} 2019 Wiley Periodicals, Inc.",
year = "2019",
month = may,
doi = "10.1002/hed.25579",
language = "English",
volume = "41",
pages = "1475--1483",
journal = "Head and Neck",
issn = "1043-3074",
publisher = "John Wiley & Sons Inc.",
number = "5",
}
