Carcinoma de células escamosas oral em pacientes jovens: uma revisão dos achados atuais

Abstract

Introduction: Oral squamous cell carcinoma (OSCC) is the most common malignant neoplasm of the oral cavity, traditionally affecting elderly individuals with a long history of chronic tobacco and alcohol use. However, over the past decades, an increase in the incidence of this type of cancer has been observed in young adults, many of whom have not been exposed to these classical risk factors. Moreover, it has been noted that in these younger patients OSCC often exhibits a more aggressive clinical behavior, resulting in worse prognoses compared to older individuals. Objectives: To investigate via a narrative review of recent publications the epidemiological patterns, potential non-traditional risk factors, and prognostic characteristics of OSCC in young adults (18–45 years), with an emphasis on non-smokers and non-drinkers (NSND), aiming to support the understanding of the rising incidence. Methodology: A literature search was conducted in the PubMed, BVS, and LILACS databases. We included full-text, publicly accessible articles published in English over the last five years. The search strategy combined the terms and descriptors “Oral Squamous Cell Carcinoma” AND “Young” AND “Prognosis” using the Boolean operator “AND.” Results: HPV (human papillomavirus) was not included as a variable in the analysis. The five studies analyzed indicate that the etiology of OSCC in young adults remains uncertain. In these studies, the tongue was the predominant site of occurrence, and an increased incidence among female patients was noted. Distinctions were made between the posterior one-third and the anterior two-thirds of the tongue. Higher recurrence rates and lower disease-specific survival were observed in patients under 45 compared to those over 45. No study evaluated electronic cigarette use. Conclusion: We propose standardizing definitions for “young adult” age ranges, as well as for the amount and duration of tobacco and alcohol exposure. We recommend public health policies promoting early screening—particularly of the tongue—and heightened awareness of rising incidence among women. Individualized surgical protocols and early therapeutic strategies should also be developed to address the worse disease-specific survival observed in young adults.