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Tobacco-related cancers decrease

CDC report stresses vigilance

Atlanta—The Centers for Disease Control and Prevention reports finding significant decreases over a recent five-year period in cancers that occur in the lung and bronchus, larynx, oral cavity and pharynx. These cancers "have the greatest average relative risks associated with tobacco use," the CDC said.

However, this rate of progress is unlikely to continue, said the CDC report, Surveillance for Cancers Associated with Tobacco Use – United States, 1999-2004. "Although advances have been made in knowledge of tobacco use and its health consequences, intervention strategies to reduce tobacco use must continue."

The tripartite dental profession is engaged in a nationwide campaign to increase public awareness of oral cancer. ADA President Mark J. Feldman joined dental volunteers at New York's Shea Stadium Sept. 9 inviting baseball fans to oral cancer screenings sponsored by the Queens County Dental Society. "We told the crowd that early detection is key to survival," he said.

William Bayer, QCDS executive director, thanked the New York State Dental Foundation and Major League Baseball's New York Mets for delivering the oral cancer screening message. The ADA offers oral cancer information for the public and the profession on ADA.org.

Oral cavity and pharyngeal cancer is the eighth most common cancer in the United States among men but is less common among women, said the CDC analysis of state-level cancer incidence data. However, the highest rates of OCP cancer in men and women occur in the oral cavity as opposed to other anatomic subsites. This type of cancer includes tumors with origins in several anatomic organs of the head and neck.

"Strong evidence associates tobacco as the carcinogenic factor in squamous cell cancer of the head and neck, which the findings from this study indicate is the predominant histologic type of OCP cancers in the United States," the CDC said. "Smokeless tobacco use also is strongly associated with OCP cancer. Among women, OCP cancers were highest among whites, a finding that might partly be related to the higher prevalence of smokeless tobacco use among white men and women."

Dr. Scott L. Tomar, professor and chair of the department of community dentistry and behavioral science at the University of Florida College of Dentistry, is a consultant on tobacco issues for the ADA Council on Access, Prevention and Interprofessional Relations. "The good news is that the overall incidence of cancers of the oral cavity and pharynx (OCP) had declined for black and white men and women during the past 20 years, which largely reflects the decline in the prevalence of smoking since the 1970s," he said.

"Unfortunately, we have made relatively little progress in detecting OCP at earlier stages. Overall, about two-thirds of cases are diagnosed at late stages that have a relatively poor prognosis, which is not appreciably different from the situation 20 years ago, even though most tumors arise at anatomical sites that can be visualized in a thorough, systematic examination."