Tobacco use in patients with head and neck carcinomas: Habit changes and second primary oral/oropharyngeal cancers in patients from San Francisco

Background - The association between smoking and head and neck carcinoma is well known, with an increased risk of developing second oral/oropharyngeal primary carcinomas in patients who continue to smoke after treatment. The aim of this study was to reconfirm the association between tobacco use in patients with head and neck carcinoma and an increased risk of developing multiple oral/oropharyngeal carcinomas using a large study group. Methods - 403 patients with head and neck carcinomas were followed for a mean time of 5.1 years (median 4.5 years). Results - Of the 403 patients, 72% used tobacco and 58% smoked more than one pack of cigarettes per day. Of those who continued to smoke without any alterations in their habit after the diagnosis of their first oral/oropharyngeal cancer, 36.2% developed a second primary lesion, which was much higher than the rate among non-smokers (14.4%), smokers who quit (13.4 %), or those who continued to smoke but at a reduced rate (14%). Conclusions - Tobacco as a high risk co-factor in the development of second primary carcinoma of the oral/oropharyneal region is well established.