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Lan R, Galieri AC, Catherine JH, Tardivo D. Oral cancer: Current status and public health perspectives. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:93-105. [PMID: 38040651 DOI: 10.3917/spub.hs1.2023.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Despite advances in surgical and oncological treatments, the incidence and five-year survival rates (~50 percent) of oral cancers (OC) have not improved over the last decades and remain a major public health problem. Seventy percent are still diagnosed at a late stage (T3 or T4), with an average delay in diagnosis of two to five months. As the cure and survival of patients are directly related to the development stage of the tumor at the time of diagnosis, the objective of this work was to analyze all the determinants related to oral cancer and to propose new clinical approaches for diagnosis and screening. A proposal for new models of screening, training, and concrete action to improve public awareness of the major global problem of OC is made. The strengths and weaknesses of OC screening studies need to be objectively understood to effectively guide and energize testing in primary care settings, with the prospect of using new and emerging technologies that can help improve the discriminatory accuracy of case detection. Most national organizations have not, to date, recommended population-based mass screening, due to a lack of sufficient scientific evidence of associated mortality reduction. Where health care resources are high, opportunistic individual screening is recommended, although the low diagnostic capacity of front-line clinicians is alarming.
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Deshpande M, Meshram M, Paul P, Reche A, Bhowate RR, Deshpande A, Borkar S. Assessment of Cancer Patients' Relatives' Knowledge, Perception, and Attitude Toward Cancer. Cureus 2023; 15:e43457. [PMID: 37711954 PMCID: PMC10498802 DOI: 10.7759/cureus.43457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/14/2023] [Indexed: 09/16/2023] Open
Abstract
Background Assessment of cancer patients' relatives' knowledge, perception, and attitude regarding cancer. To spread awareness about oral cancer in areas with a high prevalence of cancer, aid in its prevention, and accelerate the treatment to facilitate early-stage disease elimination and improve prognosis. Material and methods A cross-sectional study conducted at a hospital was done, where 23 questions were posed to the relatives of the patients admitted to the hospital. The questions were formulated to assess the knowledge of relatives regarding cancer, their perception, and their attitude toward the decision-making and treatment protocols. The questions also included information about the patient's habits and associated problems with it. A total of 400 relatives participated in the study, where all participants were adequately informed beforehand, and their written consent was taken before proceeding with the questions. All the questions were formulated in the native language that they could easily understand. Result The study found that participants had limited knowledge about the causes, treatment, prevention, and recurrence of oral cancer. Additionally, the family members were unsupportive of therapy and delayed seeking medical care. Conclusion It is crucial to raise awareness about oral cancer and inform individuals about available treatments, government programs, and counseling services to aid them in decision-making.
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Affiliation(s)
- Mihika Deshpande
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mrunal Meshram
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Priyanka Paul
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amit Reche
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rahul R Bhowate
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anvika Deshpande
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shreyash Borkar
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Perera I, Amarasinghe H, Jayasinghe RD, Udayamalee I, Jayasuriya N, Warnakulasuriya S, Johnson NW. An overview of the burden of oral cancer in Sri Lanka and its inequalities in the face of contemporary economic and social malaise. Community Dent Oral Epidemiol 2023. [PMID: 37377376 DOI: 10.1111/cdoe.12888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVES Over the past several decades, oral cancer has been the most common malignancy among Sri Lankan males and the top 10 cancer among females, disproportionately affecting low socio-economic groups. Sri Lanka is a lower-middle-income developing country (LMIC), currently striking through an economic crisis, and social and political unrest. Occurring at an accessible body site and predominantly attributed to potentially modifiable health-related behaviours, oral cancer should be preventable and controllable. Unfortunately, broader contextual factors that are socio-cultural, environmental, economic, and political and mediated through social determinants of people's lives consistently hinder progress. Many LMICs with a high burden of oral cancer are now gripped by economic crises, consequent social and political unrest, all compounded by reduced public health investments. The aim of this review is to provide a critical commentary on key aspects of oral cancer epidemiology including inequalities, using Sri Lanka as a case study. METHODS The review synthesizes evidence from multiple data sources, such as published studies, web-based national cancer incidence data, national surveys on smokeless tobacco (ST) and areca nut use, smoking and alcohol consumption, poverty headcount ratios, economic growth, and Gross Domestic Product (GDP) health expenditure. National trends in the oral cancer, ST use, smoking and alcohol consumption in Sri Lanka are identified alongside inequalities. RESULTS Using these evidence sources, we discuss 'where are we now?', together with the availability, accessibility and affordability of oral cancer treatment services, oral cancer prevention and control programmes, tobacco and alcohol control policies, and finally, outline macroeconomic perspectives of Sri Lanka. CONCLUSIONS Finally, we speculate, 'where to next?' Our overarching goal of this review is to initiate a critical discourse on bridging the gaps and crossing the divides to tackle oral cancer inequalities in LMIC such as Sri Lanka.
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Affiliation(s)
- Irosha Perera
- Preventive Oral Health Unit, National Dental Hospital (Teaching), Colombo, Sri Lanka
| | - Hemantha Amarasinghe
- Department of Community Dental Health, Faculty of Dental Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Ruwan D Jayasinghe
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Iresha Udayamalee
- School of Dentistry and Oral Health, Menzies Health Institute Queensland, Griffith University, Griffith, Queensland, Australia
| | - Nadeena Jayasuriya
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College, London and the WHO Collaborating Centre for Oral Cancer, London, UK
| | - Newell W Johnson
- School of Dentistry and Oral Health, Menzies Health Institute Queensland, Griffith University, Griffith, Queensland, Australia
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College, London and the WHO Collaborating Centre for Oral Cancer, London, UK
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Mavedatnia D, Hathi K, Feschuk AM, Grose EM, Eskander A. Individuals Experiencing Homelessness: A Systematic Review of Otolaryngology-Related Health Needs and Community-Based Interventions. Otolaryngol Head Neck Surg 2023; 168:1301-1311. [PMID: 36939409 DOI: 10.1002/ohn.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Access to and use of physician services is limited for those experiencing homelessness. Homelessness may predispose patients to several Otolaryngology-Head and Neck Surgery (OHNS) health conditions and barriers to care may leave these unaddressed. The aim of this review was to synthesize the literature on OHNS health needs and community-based interventions for patients experiencing homelessness. DATA SOURCES English literature was searched in MEDLINE, EMBASE, and CINAHL. REVIEW METHODS Studies were included if they reported on OHNS-related conditions in patients experiencing homelessness and/or interventions related to providing OHNS care to this patient population. RESULTS Twelve hundred and one articles were screened, and 12 articles were included. Most studies reported on otologic conditions (n = 8) and head and neck-related conditions (n = 6). Nasal trauma, chronic rhinosinusitis, dysphonia, hearing loss, and cancerous/precancerous head and neck lesions were common OHNS conditions reported in this patient population. Identified barriers to care included lack of transportation, financial considerations, and lower health literacy. Three articles on community-based interventions were included. Most of these interventions were single visits to shelters, and ensuring adequate follow-up was identified as a challenge. CONCLUSION The current literature brings attention to certain OHNS diseases that are prevalent in this unique patient population and identifies unique barriers these patients experience when accessing care. Future studies should focus on further delineating the impact of OHNS diseases in patients experiencing homelessness and screening interventions that can be employed to mitigate the impact of diseases of the head and neck.
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Affiliation(s)
- Dorsa Mavedatnia
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kalpesh Hathi
- Faculty of Medicine, Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada
| | - Aileen M Feschuk
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Elysia M Grose
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital, Toronto, Ontario, Canada
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Toronto, Canada
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Barboza Solís C, Reyes-Carmona J, Fantin R. Social inequality in incidence and mortality of malignant neoplasms of lip, oral cavity and pharynx: Is Costa Rica an international paradox? Community Dent Oral Epidemiol 2021; 50:243-250. [PMID: 34076287 DOI: 10.1111/cdoe.12658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Low socioeconomic position (SEP) has been associated with higher incidences and mortality of lip, oral cavity and pharynx (LOP) cancers in the vast majority of countries with available data. The origins of health inequalities in cancer are socioeconomic, although they vary by time and country. Evidence from Low-and Middle-income Countries (LMICs) remains scarce. This study aims to identify and describe socioeconomic inequalities in LOP cancers incidence and mortality in Costa Rica. The hypothesis tested is that people leaving in low-SEP districts in Costa Rica have greater incidence and mortality rates of lip, oral cavity and pharynx cancers. METHODS The 10th revision of the International Classification of Diseases (ICD-10) was used to define cancer sites. Data come from a national population-based Cancer Registry with 100% completeness to study incidence. Incidence rate included all new cases of LOP cancer diagnosed from January 1, 2011, and December 31, 2015, for a total of 2 798 517 individuals, 13 832 524 years of follow-up and 601 LOP cases. Mortality rate was extracted from the National Death Index, including 2 739 733 individuals, 23 950 240 person-years of follow-up and 586 LOP cancer deaths, from January 1, 2010, to December 31, 2018. The 2011 Census (with 94% of Costa Rican inhabitants) was used to characterize the urbanicity and wealth of 477 districts. Survival models were performed for both incidence and mortality, allowing to consider existing competitive risks. Cox models were used for incidence, and parametric survival models based on a Gompertz distribution for mortality. RESULTS The study found that people who lived in the most socioeconomically disadvantaged areas had lower probabilities of developing LOP cancers than people in the richest districts. The same pattern for mortality, however, was not significant. CONCLUSIONS The hypothesis that incidence and mortality of LOP cancers will show a positive social gradient was not confirmed in this study, contradicting the existing literature. This could be explained by the social distribution of risky health behaviours, more frequent in socially advantaged populations.
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Affiliation(s)
| | | | - Romain Fantin
- Centro Centroamericano de Población, Universidad de Costa Rica, San José, Costa Rica.,Escuela de Salud Pública, Facultad de Medicina, Universidad de Costa Rica, San José, Costa Rica.,Escuela de Medicina, Facultad de Medicina, Universidad de Costa Rica, San José, Costa Rica
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Nagao T, Warnakulasuriya S. Screening for oral cancer: Future prospects, research and policy development for Asia. Oral Oncol 2020; 105:104632. [PMID: 32315954 DOI: 10.1016/j.oraloncology.2020.104632] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/05/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023]
Abstract
Although the incidence of oral cavity cancer is high among low and middle income countries in Asia where the risk habits (tobacco smoking, tobacco chewing and betel quid use) are common, the benefits for introducing oral cancer screening for the whole population in these countries still remains controversial. It is disappointing, but not surprising that many of studies, without control arms, could not provide a clear answer as to whether screening is effective in reducing mortality or combating rising incidence trends. Only one Indian study that reported a randomized controlled trial (RCT) elucidated that mass screening for high risk groups could significantly reduce the cancer mortality or down-stage cancers detected by screening. Several professional organizations that considered any potential benefits of oral cancer screening remain unconvinced that the current knowledge on its natural history, available tests and interventions to treat potentially malignant disorders satisfy the desirable criteria to recommend organized screening for oral cancer. In this review we discuss advantages and disadvantages for oral cancer screening particularly with reference to high incidence countries in Asia. If screening is undertaken, we propose that it is targeted to high risk groups and to combine screening with education on risky life-styles so that overall incidence can be reduced in the future. Further research on increasing public awarenes and impact of professional education such as e-learning to reduce diagnostic delays, studies on the natural history of oral potentially malignant disorders and cancer, comprehensive tobacco and areca nut cessation programs, developing tools to identify high-risk individuals and high-risk lesions are proposed.
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Affiliation(s)
- Toru Nagao
- Department of Maxillofacial Surgery School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, UK
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Taib B, Oakley J, Dailey Y, Hodge I, Wright P, du Plessis R, Rylands J, Taylor-Robinson D, Povall S, Schache A, Shaw R, Dingle A, Jones T. Socioeconomic deprivation and the burden of head and neck cancer-Regional variations of incidence and mortality in Merseyside and Cheshire, North West, England. Clin Otolaryngol 2018; 43:846-853. [PMID: 29341454 DOI: 10.1111/coa.13067] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 01/23/2023]
Affiliation(s)
- B.G. Taib
- Royal Liverpool University Hospital; Liverpool UK
| | - J. Oakley
- Cheshire West and Chester Public Health Team; Chester UK
| | - Y. Dailey
- Public Health North West England; Cheshire and Merseyside PHE Centre; Liverpool UK
| | - I. Hodge
- Cheshire and Merseyside Strategic Clinical Networks; Stockton Heath; Warrington UK
| | - P. Wright
- Cheshire West and Chester Public Health Team; Chester UK
| | - R. du Plessis
- Cheshire and Merseyside Collaborative Service; Bromborough Wirral UK
| | - J. Rylands
- Aintree University Hospital; Liverpool UK
| | - D. Taylor-Robinson
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
| | - S. Povall
- Department of Public Health and Policy; University of Liverpool; Liverpool UK
| | - A. Schache
- Northwest Cancer Research Centre; University of Liverpool; Liverpool UK
| | - R. Shaw
- Northwest Cancer Research Centre; University of Liverpool; Liverpool UK
| | - A. Dingle
- Cheshire and Merseyside Strategic Clinical Networks; Sci-Tech Daresbury; Daresbury UK
| | - T.M. Jones
- Northwest Cancer Research Centre; University of Liverpool; Liverpool UK
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Taib BG, Rylands J, Povall S, Jones TM, Taylor-Robinson D. Protocol: systematic review of the association between socio-economic status and survival in adult head and neck cancer. Syst Rev 2017; 6:151. [PMID: 28768525 PMCID: PMC5541745 DOI: 10.1186/s13643-017-0545-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 07/18/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Head and neck cancer incidence is increasing worldwide. Despite overall improvements in survival, numerous studies suggest worse survival in more disadvantaged populations; however, this literature has not been systematically reviewed. The aim of this review is to investigate whether lower compared to higher socioeconomic status (SES) influences survival in head and neck squamous cell cancer (HNSCC) and explore possible explanations for any relationship found. METHOD A systematic strategy will be used to identify articles, appraise their quality and extract data. Online databases including MEDLINE, Web of Knowledge, ESBCO Host and Scopus will be used to locate observational studies of adults with a primary diagnosis of head and neck cancer in EU15+ countries (15 members of the EU, Australia, Canada, Norway, USA and New Zealand) where the outcomes report associations between SES and survival. This will be augmented by searching for grey literature and through reference lists. Data will be extracted using a standardised form. Study quality will be assessed using the Newcastle Ottawa scale and where possible meta-analysis of the pooled data will be conducted. DISCUSSION This review will quantify the association between SES and survival outcomes for adult head and neck cancer patients in developed countries. The results will help identify gaps in the literature and therefore direct further novel research in the field. Ultimately, this will inform public policy and strategies to reduce the inequalities in HNSCC survival. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016037019 .
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Affiliation(s)
- Bilal G. Taib
- Postgraduate Centre, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP UK
| | - Joseph Rylands
- Aintree University Hospital, Longmoor Lane, Liverpool, L9 7AL UK
| | - Sue Povall
- Institute of Psychology, Health and Society, University of Liverpool, Waterhouse building, Liverpool, L69 3BX UK
| | - Terry M. Jones
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, 200 London Road, Liverpool, L3 9GA UK
| | - David Taylor-Robinson
- Institute of Psychology, Health and Society, University of Liverpool, Waterhouse building, Liverpool, L69 3BX UK
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Mahdavifar N, Towhidi F, Makhsosi BR, Pakzad R, Moini A, Ahmadi A, Lotfi S, Salehiniya H. Incidence and Mortality of Nasopharynx Cancer and Its Relationship With Human Development Index in the World in 2012. World J Oncol 2016; 7:109-118. [PMID: 28983375 PMCID: PMC5624652 DOI: 10.14740/wjon980w] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND One of the most common cancers in head and neck is nasopharynx. Knowledge about the incidence and mortality of this disease and its distribution in terms of geographical areas is necessary for further study, better planning and prevention. Therefore, this study aimed to determine the incidence and mortality of nasopharynx cancer and its relationship with human development index (HDI) in the world in 2012. METHODS This study was an ecological study conducted based on GLOBOCAN project of World Health Organization (WHO) for the countries in world. The correlation between standardized incidence rates (SIRs) and standardized mortality rates (SMRs) of nasopharynx cancer with HDI and its components was assessed with correlation coefficient by using SPSS 15. RESULTS In 2012, 86,691 nasopharynx cancer cases occurred in the world, so that 60,896 new cases were seen in men and 25,795 new cases in women (sex ratio = 2.36). SIR of the cancer was 1.2 per 100,000 (1.7 in men and 0.7 in women per 100,000) in the world. In 2012, 50,831 nasopharynx death cases occurred in the world, so that 35,756 death cases were seen in men and 15,075 death cases in women (sex ratio = 2.37). SIR of mortality from the cancer was 0.7 per 100,000 (0.7 in women and 1 in men per 100,000) in the world. The results of correlation analysis showed a negative correlation between the SIR and HDI (r = -0.037, P = 0.629), and also the results of correlation analysis showed a negative correlation between the SMR and HDI (r = -0.237, P = 0.002). CONCLUSION Nasopharyngeal cancer is native to Southeast Asia and the highest incidence and mortality were seen in countries with moderate and low HDI. It is suggested that studies are conducted on determining the causes of the cancer incidence and mortality in the world and the differences between various regions.
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Affiliation(s)
- Neda Mahdavifar
- Health Promotion Research Center, Department of Epidemiology and Biostatistics, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farhad Towhidi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Reza Pakzad
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Moini
- Department of Internal Medicine, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abbas Ahmadi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sarah Lotfi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Salehiniya
- Zabol University of Medical Sciences, Zabol, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Outcomes by area of residence deprivation in a cohort of oral cancer patients: Survival, health-related quality of life, and place of death. Oral Oncol 2016; 52:30-6. [DOI: 10.1016/j.oraloncology.2015.10.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 10/12/2015] [Accepted: 10/16/2015] [Indexed: 11/30/2022]
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Gender differences in prognostic factors for oral cancer. Int J Oral Maxillofac Surg 2015; 44:1205-11. [DOI: 10.1016/j.ijom.2015.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 11/23/2022]
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Conway DI, Brenner DR, McMahon AD, Macpherson LMD, Agudo A, Ahrens W, Bosetti C, Brenner H, Castellsague X, Chen C, Curado MP, Curioni OA, Dal Maso L, Daudt AW, de Gois Filho JF, D'Souza G, Edefonti V, Fabianova E, Fernandez L, Franceschi S, Gillison M, Hayes RB, Healy CM, Herrero R, Holcatova I, Jayaprakash V, Kelsey K, Kjaerheim K, Koifman S, La Vecchia C, Lagiou P, Lazarus P, Levi F, Lissowska J, Luce D, Macfarlane TV, Mates D, Matos E, McClean M, Menezes AM, Menvielle G, Merletti F, Morgenstern H, Moysich K, Müller H, Muscat J, Olshan AF, Purdue MP, Ramroth H, Richiardi L, Rudnai P, Schantz S, Schwartz SM, Shangina O, Simonato L, Smith E, Stucker I, Sturgis EM, Szeszenia-Dabrowska N, Talamini R, Thomson P, Vaughan TL, Wei Q, Winn DM, Wunsch-Filho V, Yu GP, Zhang ZF, Zheng T, Znaor A, Boffetta P, Chuang SC, Ghodrat M, Amy Lee YC, Hashibe M, Brennan P. Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries. Int J Cancer 2014; 136:1125-39. [PMID: 24996155 DOI: 10.1002/ijc.29063] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 02/21/2014] [Accepted: 03/20/2014] [Indexed: 12/21/2022]
Abstract
Low socioeconomic status has been reported to be associated with head and neck cancer risk. However, previous studies have been too small to examine the associations by cancer subsite, age, sex, global region and calendar time and to explain the association in terms of behavioral risk factors. Individual participant data of 23,964 cases with head and neck cancer and 31,954 controls from 31 studies in 27 countries pooled with random effects models. Overall, low education was associated with an increased risk of head and neck cancer (OR = 2.50; 95% CI = 2.02 - 3.09). Overall one-third of the increased risk was not explained by differences in the distribution of cigarette smoking and alcohol behaviors; and it remained elevated among never users of tobacco and nondrinkers (OR = 1.61; 95% CI = 1.13 - 2.31). More of the estimated education effect was not explained by cigarette smoking and alcohol behaviors: in women than in men, in older than younger groups, in the oropharynx than in other sites, in South/Central America than in Europe/North America and was strongest in countries with greater income inequality. Similar findings were observed for the estimated effect of low versus high household income. The lowest levels of income and educational attainment were associated with more than 2-fold increased risk of head and neck cancer, which is not entirely explained by differences in the distributions of behavioral risk factors for these cancers and which varies across cancer sites, sexes, countries and country income inequality levels.
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Affiliation(s)
- David I Conway
- Glasgow Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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Hwang E, Johnson-Obaseki S, McDonald JT, Connell C, Corsten M. Incidence of head and neck cancer and socioeconomic status in Canada from 1992 to 2007. Oral Oncol 2013; 49:1072-6. [PMID: 24018186 DOI: 10.1016/j.oraloncology.2013.08.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 05/05/2013] [Accepted: 08/14/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the association between head and neck cancer (HNC) incidence and socioeconomic status (SES) in Canada, and investigate changes in the relationship between HNC incidence and SES from 1992 to 2007. MATERIALS AND METHODS Cases were drawn from the Canadian Cancer Registry (1992-2007), and were categorized into three subsites: oropharynx, oral cavity, and "other" (hypopharynx, larynx, and nasopharynx). Demographic and socioeconomic information were extracted from the Canadian Census of Population data for the study period (1992-2007), which included four census years. We linked cases to income quintiles (InQs) according to patients' postal codes. RESULTS Incidence rates in the lowest InQs were significantly higher than in the highest InQs for all HNC subsites. The incidence of oropharyngeal cancer increased over the time period 1992-2007 for all InQs. However, the greatest increase in incidence was in the highest InQs. As a result, over the time period the gap between the incidence of the highest and lowest InQs significantly narrowed for oropharyngeal cancer. For oral cavity cancer and the other head and neck cancers, the overall incidence did not increase and the gap in incidence did not change significantly. CONCLUSION HNC incidence was higher with lower income in all HNC subsites in Canada from 1992 to 2007. The gap in incidence between the highest and the lowest InQs narrowed for oropharyngeal cancer over the time period studied, but was unchanged for the other HNC subsites.
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Affiliation(s)
- Euna Hwang
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Canada
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Traumatic dental injury and social deprivation in five-year-old children in Scotland 1993-2007. Br Dent J 2013; 214:E26. [DOI: 10.1038/sj.bdj.2013.505] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2012] [Indexed: 11/08/2022]
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Radespiel-Tröger M, Meyer M, Fenner M. Geographic differences and time trends of intraoral cancer incidence and mortality in Bavaria, Germany. J Craniomaxillofac Surg 2012; 40:e285-92. [DOI: 10.1016/j.jcms.2012.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 01/03/2012] [Accepted: 01/04/2012] [Indexed: 11/17/2022] Open
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Sharpe KH, McMahon AD, McClements P, Watling C, Brewster DH, Conway DI. Socioeconomic inequalities in incidence of lung and upper aero-digestive tract cancer by age, tumour subtype and sex: a population-based study in Scotland (2000-2007). Cancer Epidemiol 2012; 36:e164-70. [PMID: 22436397 DOI: 10.1016/j.canep.2012.01.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 12/13/2011] [Accepted: 01/30/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Lung and upper aero-digestive tract (UADT) cancer risk is associated with socioeconomic inequality (SEI) but the degree of socioeconomic burden by age, tumour subtype, and sex is not known. METHODS We reviewed 216,305 cases excluding non melanoma skin cancer (All Cancer) comprising 37,274 lung; 8216 head and neck; and 6534 oesophageal cancers from 2000 to 2007 classified into anatomical or morphology subtypes. Deprivation was measured using the Scottish Index of Multiple Deprivation and SEI was measured using the Slope Index of Inequality and the Relative Index of Inequality (RII). Analyses were partitioned by 5-year age group and sex. RII was adapted to rank tumour type contribution to All Cancer SEI and to examine subtype by age and sex simultaneously. Rank was defined as proportion of All Cancer SEI. RESULTS All Cancer SEI was greater for males (RII=0.366; female RII=0.279); the combination of lung and UADT SEI contributed 91% and 81% respectively to All Cancer SEI. For both sexes lung and UADT subtypes showed significant SEI (P<0.001) except oesophageal adenocarcinoma in males (P=0.193); for females, SEI was borderline significant (P=0.048). Although RII rank differed by sex, all lung and larynx subtypes contributed most to All Cancer SEI with RII rank for oral cavity, oesophagus-squamous cell, and oropharynx following. For males 40-44 years, SEI increased abruptly peaking at 55-59 years. For females, SEI gradually peaked 10 years later. In both sexes, the SEI peak preceded peak incidence. CONCLUSION SEI in lung and UADT cancers vary greatly by age, tumour subtype and sex; these variations are likely to largely reflect differences between the sexes in risk behaviours which vary by birth cohort and are socioeconomically patterned.
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Affiliation(s)
- Katharine H Sharpe
- Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, UK.
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17
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Shaw RJ, Pace-Balzan A, Butterworth C. Contemporary clinical management of oral squamous cell carcinoma. Periodontol 2000 2011; 57:89-101. [PMID: 21781181 DOI: 10.1111/j.1600-0757.2011.00392.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The classification of sites in tumors of the oral cavity, oropharynx, pharynx, and hypopharynx varies in the literature. More than 90% of these tumors of the mucosal lining are classified as squamous cell carcinoma developed from premalignant lesions such as leukoplakia and erythroleukoplakia. These carcinomas are associated to environmental and lifestyle risk factors, among which tobacco and alcohol play a major role. In addition to tobacco smoking, tobacco chewing is another risk factor as well as chewing betel quid and areca nut in Asia. Certain strains of virus, such as the sexually transmitted human papilloma virus, also play a carcinogenetic role. The temporal trends in incidence of these tumors relate to environmental factors; there is an increase in tendency in countries without prevention and a decrease in countries having an active policy of prevention of alcohol and tobacco consumption. In contrast, an increased incidence occurs in the world at tumor sites related to human papilloma virus infection in relation to changes in sexual habits.
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Shaw RJ, Lowe D, Woolgar JA, Brown JS, Vaughan ED, Evans C, Lewis-Jones H, Hanlon R, Hall GL, Rogers SN. Extracapsular spread in oral squamous cell carcinoma. Head Neck 2010; 32:714-22. [PMID: 19827119 DOI: 10.1002/hed.21244] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Extracapsular spread (ECS) in the cervical lymph nodes represents the most significant adverse prognostic indicator in oral squamous cell carcinoma (OSCC). METHODS In a consecutive cohort of OSCC treated by primary surgery, ECS was seen in 25% (101) of 400 patients. RESULTS ECS doubled the incidence of local recurrence and distant metastases, but tripled regional failure. The recurrences occurred sooner in ECS than in non-ECS cases (206 vs 334 days, p = .04). Patients with macroscopic ECS had a 5-year overall survival (OS) of 19% compared with 31% in microscopic ECS. MRI neck staging offered poor sensitivity, especially in microscopic ECS. Age >75 years, smoking, and heavy use of alcohol were independent predictors of ECS, which may implicate a failure of immunosurveillance by the host as much as adverse biology of the tumor. CONCLUSIONS Reporting of ECS is essential in accurate prognostication, and we advocate that all patients with OSCC and ECS should be grouped as pN3 on the basis of their prognosis. (c) 2009 Wiley Periodicals, Inc. Head Neck, 2010.
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Affiliation(s)
- Richard J Shaw
- Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, United Kingdom.
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20
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Doherty VR, Brewster DH, Jensen S, Gorman D. Trends in skin cancer incidence by socioeconomic position in Scotland, 1978-2004. Br J Cancer 2010; 102:1661-4. [PMID: 20442712 PMCID: PMC2883152 DOI: 10.1038/sj.bjc.6605678] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Non-melanoma skin cancer has been little studied in relation to deprivation. Methods: Incident cases diagnosed in 1978–2004 were extracted from the Scottish Cancer Register and assigned to quintiles of Carstairs deprivation scores. Age-standardised incidence rates (ASRs) (European standard population) were calculated by deprivation quintile, sex, period of diagnosis, for the three main types of skin cancer. Results and conclusion: As age-standardised incidence of each skin cancer increased significantly over time across all deprivation categories, rates were consistently highest in the least deprived quintile.
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Affiliation(s)
- V R Doherty
- Department of Dermatology, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3 9HA, UK.
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21
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Johnson S, McDonald JT, Corsten M, Rourke R. Socio-economic status and head and neck cancer incidence in Canada: A case-control study. Oral Oncol 2010; 46:200-3. [DOI: 10.1016/j.oraloncology.2009.12.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Revised: 12/14/2009] [Accepted: 12/15/2009] [Indexed: 11/26/2022]
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22
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Conway DI, McKinney PA, McMahon AD, Ahrens W, Schmeisser N, Benhamou S, Bouchardy C, Macfarlane GJ, Macfarlane TV, Lagiou P, Minaki P, Bencko V, Holcátová I, Merletti F, Richiardi L, Kjaerheim K, Agudo A, Castellsague X, Talamini R, Barzan L, Canova C, Simonato L, Lowry RJ, Znaor A, Healy CM, McCartan BE, Marron M, Hashibe M, Brennan P. Socioeconomic factors associated with risk of upper aerodigestive tract cancer in Europe. Eur J Cancer 2009; 46:588-98. [PMID: 19857956 DOI: 10.1016/j.ejca.2009.09.028] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 09/25/2009] [Accepted: 09/30/2009] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In the European Union, there are 180,000 new cases of upper aerodigestive tract (UADT) cancer cases per year--more than half of whom will die of the disease. Socioeconomic inequalities in UADT cancer incidence are recognised across Europe. We aimed to assess the components of socioeconomic risk both independently and through their influence on the known behavioural risk factors of smoking, alcohol consumption and diet. PATIENTS AND METHODS A multicentre case-control study with 2198 cases of UADT cancer and 2141 controls from hospital and population sources was undertaken involving 14 centres from 10 countries. Personal interviews collected information on demographics, lifetime occupation history, smoking, alcohol consumption and diet. Socioeconomic status was measured by education, occupational social class and unemployment. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using unconditional logistic regression. RESULTS When controlling for age, sex and centre significantly increased risks for UADT cancer were observed for those with low versus high educational attainment OR=1.98 (95% CI 1.67, 2.36). Similarly, for occupational socioeconomic indicators--comparing the lowest versus highest International Socio-Economic Index (ISEI) quartile for the longest occupation gave OR=1.60 (1.28, 2.00); and for unemployment OR=1.64 (1.24, 2.17). Statistical significance remained for low education when adjusting for smoking, alcohol and diet behaviours OR=1.29 (1.06, 1.57) in the multivariate analysis. Inequalities were observed only among men but not among women and were greater among those in the British Isles and Eastern European countries than in Southern and Central/Northern European countries. Associations were broadly consistent for subsite and source of controls (hospital and community). CONCLUSION Socioeconomic inequalities for UADT cancers are only observed among men and are not totally explained by smoking, alcohol drinking and diet.
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Affiliation(s)
- D I Conway
- Dental School, Faculty of Medicine, University of Glasgow, 378 Sauchiehall Street, Glasgow G2 3JZ, UK.
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Conway DI, McMahon AD, Smith K, Black R, Robertson G, Devine J, McKinney PA. Components of socioeconomic risk associated with head and neck cancer: a population-based case-control study in Scotland. Br J Oral Maxillofac Surg 2009; 48:11-7. [PMID: 19481316 DOI: 10.1016/j.bjoms.2009.03.020] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2009] [Indexed: 10/20/2022]
Abstract
The complex associations between socioeconomic circumstances and risk for head and neck cancer are under-explored. We investigated components of social class and their relative influence on the risk of head and neck cancers by studying 103 patients (age range 24-80 years) who had been diagnosed with cancer of the head and neck between April 2002 and December 2004, and 91 controls who were randomly selected from general practitioners' lists. Information about occupation, education, smoking, and alcohol consumption was collected at personal interview. Socioeconomic circumstances were measured at an individual level (education, occupational social class, unemployment), and by area-based measures of deprivation. Odds ratios (OR) and 95% confidence intervals (CI) were computed using unconditional logistic regression and multivariate analyses. People living in the most deprived areas (OR=4.66, 95% CI 1.79-12.18); and those who were unemployed (OR=2.27, 95% CI 1.21-4.26) had a significantly higher risk of cancer than those with high levels of educational attainment (OR=0.17, 95% CI 0.05-0.58). Significance was lost for all measures of social class when adjustments were made for smoking and consumption of alcohol. Smoking was the only significant risk factor (OR=15.53, 95% CI 5.36-44.99) in the multivariate analysis. A high risk of head and neck cancer was consistently associated with poor socioeconomic circumstances, and there were strong links for specific components however smoking dominated the overall profile of risk. We propose a framework for future socioeconomic analyses.
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Affiliation(s)
- David I Conway
- University of Glasgow, Faculty of Medicine, Dental School, Glasgow, UK.
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Doobaree IU, Landis SH, Linklater KM, El-Hariry I, Moller H, Tyczynski J. Head and neck cancer in South East England between 1995-1999 and 2000-2004: An estimation of incidence and distribution by site, stage and histological type. Oral Oncol 2009; 45:809-14. [PMID: 19251472 DOI: 10.1016/j.oraloncology.2008.12.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 12/18/2008] [Accepted: 12/18/2008] [Indexed: 11/29/2022]
Abstract
Population-based data on head and neck cancer (HNC) stage and histological type are poorly described for England; these data are essential for clinical management and research. The aim of this study was to describe the distribution and incidence of all HNC and selected anatomical sites by sex, age, stage and histological type using a population-based cancer registry in South East England, and determine if the incidence changed between 1995-1999 and 2000-2004. We identified all HNC cancer cases registered by the Thames Cancer Registry for 1995-1999 and 2000-2004. Frequency distributions and age-standardised incidence rates were calculated by sex, age, stage and histological type and trends in incidence between the two time periods were described using incidence rate ratios and 95% confidence intervals. A total of 8700 HNC cases were reported in 2000-2004, representing an age-standardised incidence rate of 8.59 per 100000, which did not change significantly from 1995-1999. The three commonest HNC sites were intra-oral cavity, larynx and tonsil. Males were two to six times as likely as females to be diagnosed with HNC and there was a trend toward younger age at diagnosis over time. Significant increases in the incidence rate of intra-oral cavity cancer for both sexes and tonsillar cancer among males were observed. Conversely, laryngeal cancer incidence decreased over time. Staging data was only available for about 40% of HNC cases. Seventy six percent of HNC cases were squamous cell carcinomas. Trends in incidence varied between HNC sites, highlighting the importance of presenting data for individual HNC sites. The high proportion of unstaged cancers may result from incomplete recording in medical records; thus, the reporting of staging data should be made a priority.
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Socioeconomic factors influence selection and participation in a population-based case–control study of head and neck cancer in Scotland. J Clin Epidemiol 2008; 61:1187-93. [DOI: 10.1016/j.jclinepi.2007.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Revised: 12/05/2007] [Accepted: 12/21/2007] [Indexed: 11/19/2022]
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Menvielle G, Kunst A. Social inequalities in cancer incidence and cancer survival: Lessons from Danish studies. Eur J Cancer 2008; 44:1933-7. [DOI: 10.1016/j.ejca.2008.06.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Accepted: 06/20/2008] [Indexed: 11/25/2022]
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Socioeconomic inequalities and oral cancer risk: A systematic review and meta-analysis of case-control studies. Int J Cancer 2008; 122:2811-9. [DOI: 10.1002/ijc.23430] [Citation(s) in RCA: 249] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Anandan C, Elton R, Hitchings A, Brewster D. Nasopharyngeal cancer incidence and survival in Scotland, 1975–2001. Clin Otolaryngol 2008; 33:12-7. [DOI: 10.1111/j.1749-4486.2007.01590.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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