인구간 인종, 유전적 차이 뿐만아니라 담배, 알코올 소비와 같은 위험인자의 유병률 때문에, 두경부암의 일차적 장소와 발생률에서 큰 지역적 차이가 있습니다.
There are large geographic differences in the incidence and primary site of head and neck cancers. These likely reflect the prevalence of risk factors, such as tobacco and alcohol consumption, as well as ethnic and genetic differences among populations.
비록 두경부암의 가장 높은 비율은 고령 남성에서 발생할지라도, 젊은 비흡연자에서도 발생률이 증가되어 왔으며 이는 두경부인두암의 발생의 원인 요인으로서 HPV가 증가된 주된 역할 때문입니다.
Although the highest rates of head and neck cancer are in older males, the incidence has been increasing in young non-smokers, as human papillomavirus (HPV) plays an increasingly prominent role as an etiologic factor in the development of oropharyngeal head and neck cancer.
담배는 두경부암 발생의 가장 중요한 알려진 위험 요인이고 흡연의 발암성 효과에 대한 유전적 소인에 대한 일부 증거가 있습니다. 담배와 알코올 소비는 상승 효과가 있는 것 같습니다.
Tobacco (smoked and smokeless) is the most important known risk factor for the development of head and neck cancer. There is some evidence for a genetic predisposition to the carcinogenic effects of tobacco. In addition, tobacco and alcohol consumption appear to have a synergistic effect. The repeated exposure of the mucosa of the upper aerodigestive tract to the carcinogenic effects of tobacco, alcohol, or both appears to cause multiple primary and secondary tumors in this "condemned mucosa," a phenomenon described as "field cancerization."
HPV 감염은 두경부암의 원인 요인입니다. HPV 관련 두경부암은 주로 oropharynx (tonsils and base of tongue)에서 발생하고 젊은 oropharyngeal squamous cell carcinoma 환자를 차지합니다.
HPV infection is a causative agent for head and neck cancer. HPV associated head and neck cancers occur primarily in the oropharynx (tonsils and base of tongue), account for the younger age of patients with oropharyngeal squamous cell carcinoma, and define a subset of patients with improved treatment outcome. The use of HPV status in clinical decision-making remains investigational at this time, although there are multiple active deintensification trials currently in progress. The goal of these trials is to decrease the short- and long-term toxicity of treatment. Nonetheless treatment outside of a clinical trial remains the same as for patients without an HPV associated tumor.
Other head and neck cancer risk factors include betel nut chewing, radiation exposure, vitamin deficiencies, periodontal disease, immunosuppression, and other environmental and occupational exposures.
REF. UpToDate 2020.02.25
