Inflammatory tongue conditions associated with increased risk of oral tongue cancer

1. In this case-control study, those with tongue cancer were found to have ten-fold increases in rates of inflammatory tongue conditions (e.g., glossodynia, glossitis, precancer) preceding cancer diagnosis, and this remained significant even in conditions diagnosed ≥ 5 years prior to cancer occurrence.

2. Rates of oropharyngeal and oral cavity cancers were not found to be associated with tongue cancers.

Evidence Rating Level: 3 (Average)

Over the past decade alone, the rate at which people are being diagnosed with oral cancers, and specifically tongue cancer, is on the rise. It is well-established that certain modifiable risk factors increase risk for tongue cancer, including tobacco use, alcohol overuse, and HPV. There is also some literature to support that inflammatory states in the mouth may promote the development of tongue cancer. The current case-control study sought to investigate whether associations between certain inflammatory tongue conditions and oral cancer exist. The study population included patients with oral tongue, oral cavity, and oropharyngeal cancers (2,534, 6,832, and 9,373), as well as controls (200,000). Several inflammatory tongue conditions were included in the analysis of these patients’ medical records, including several types of glossitis, glossodynia, oral precancers, or other unspecified conditions. It was found that those with tongue cancers had significantly higher rates – ten-fold – of inflammatory conditions than healthy controls (6.0% and 0.6%, respectively; 95% CI, [4.7 to 7.2]), and this remained true even when inflammatory conditions had been diagnosed several years prior to the occurrence of the cancer (≥ five years). Oropharyngeal and other oral cancers were not found to be significantly associated with preceding inflammatory tongue conditions (p > .05). While these results are not absolute and bound to the limitations of a case-control study, there are some implications for the recognition of inflammatory tongue conditions as a risk factor for downstream oral cancers. Healthcare providers should potentially consider a heightened suspicion for oral precancers/cancers in patients with previous diagnosis of inflammatory tongue conditions, even spanning back ≥ 5 years.

Click to read the study in Journal of Clinical Oncology

Image: PD

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