Nw. Johnson et al., HEREDITARY AND ENVIRONMENTAL RISK-FACTORS - CLINICAL AND LABORATORY RISK MARKERS FOR HEAD AND NECK, ESPECIALLY ORAL, CANCER AND PRECANCER, European journal of cancer prevention, 5(1), 1996, pp. 5-17
The continuing high incidence and mortality of squamous cell carcinoma
of the upper aerodigestive tract in South Asia, parts of France and c
entral Europe, together with a rising incidence and mortality from a l
ower base elsewhere in the Western world, stimulates continuing resear
ch on risk factors and risk markers. Tobaccos (smoked and smokeless),
heavy alcohol consumption, and areca nut remain the dominant risk fact
ors, with confirmation of the protective effects of diets rich in anti
oxidants. There is emerging evidence of a small, but real, risk associ
ated with occupational and other air pollution, and with family, part
of which may be hereditary. Markers in peripheral blood and saliva are
underexploited. Clinical staging and histological grading methods con
tinue to be refined, with improved prognostic value, much aided by new
er and simpler methods for estimating cell proliferation and apoptosis
. Data on the significance of viral genes are still inadequate, but th
ere is good progress describing the epidemiology of chromosomal abnorm
alities and abberations of a growing list of oncogenes and tumour supp
ressor genes. Unfortunately, as yet, these have only limited longitudi
nal or prognostic data.