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Prevalence and major causative factors of upper aerodigestive tract malignancies

Pradeep Pooja, Chakramakal Joseph Andrews, Gopinatha Menon Arjun, Arayamparambil Rajagopalan Vinayakumar.

Background: The upper aerodigestive tract (UADT) malignancies vary with geography. Data on epidemiology of UADT are few in India, especially southern states such as Kerala.

Objective: To estimate the prevalence and major causative factors of UADT malignancies.

Materials and Methods: In this cross-sectional study, 60 patients (54 male and 6 female subjects) who showed proven UADT malignancies were included. Main epidemiological factors such as age, distribution, site, histopathological types, symptoms, and levels of lymph nodes were determined. The clinical and radiological stages of each site at the time of presentation were also assessed and statistically analyzed.

Result: The male to female ratio was 9:1, with peak incidence in 50% cases at the 6069 years age group. Most common symptom at presentation was change in voice with hoarseness (21/60) and neck swellings (18/60) with lymph node metastasis at the time of presentation. The most commonly involved site was glottis (19/60) with T1 presentation (15/19). Oral cavity lesions found in 11 of 60 cases with seven cases in T4 presentation. Hypopharyngeal malignancies were found in eight cases. Other sites found to be involved were oropharynx, nasopharynx, maxillary sinus, and salivary gland with lesser frequency. Fifty-three cases showed addictions such as tobacco smoking, alcoholism, or tobacco chewing.

Conclusion: The distribution of UADT cancers was the highest in the 6069 years age group with male:female ratio of 9:1. Glottic malignancy showed the highest frequency. Smoking and alcoholism were the major causative factors identified. Hence, the need for education and awareness that are aimed at reducing exposure habit forming substances are emphasized. This study showed limitations such as small sample size and short duration, which warranted further multicenter studies for a longer duration.

Key words: Upper aerodigestive tract malignancies, smoking, alcoholism, lymph node, glottis, oropharynx, nasopharynx, maxillary sinus, salivary gland

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