Squamous Cell Carcinoma of the Head and Neck: An Overview | Clinical Trials

Squamous cell carcinoma (SCC) makes up nearly 90% of all head and neck cancers.^1,2 This type of head and neck cancer typically includes cancers of the throat, nasal cavity, sinuses, nose, mouth, and larynx (voice box).^2,3

^{Head and neck cancers are more common in men than women, and in those over the age of 50.3, You are more likely to be impacted by head and neck cancers if you use tobacco or alcohol or if you have been diagnosed with oral human papillomavirus (HPV).3} In a recent study, Black patients with head and neck cancers had consistently worse outcomes than their white counterparts.⁴ Black patients are also less likely to receive adequate care for head and neck cancer.

Causes of Head and Neck Cancer

Many of the known causes of head and neck cancers are preventable. Awareness of these factors can help you make decisions that can lessen your risk of exposure. Principal risk factors for head and neck cancers include tobacco and alcohol use and exposure to the human papillomavirus (HPV).³

Other risk factors associated with SCC of the head and neck include:

• Exposure to harmful substances on the job, such as asbestos, dust, metals, and wood
• Ebstein-Barr virus infection
• Genetics
• Radiation treatments

Use of harmful substances

The use of any type of alcohol or tobacco is one of the two major risk factors. Inhaling tobacco smoke even if you are not smoking directly may also cause harm.³ The risk associated with developing these cancers is greater in those who use both alcohol and tobacco than it is in those who use one or the other.³

HPV infection

HPV is classified as a sexually transmitted infection (STI). Some types of HPV are associated with a risk of developing cancer. HPV infection is mostly associated with cancers of the tonsils or tongue.

How to Reduce Your Risk

Two main ways you can decrease your risk of developing SCC of the head and neck are by avoiding products that contain alcohol or tobacco and protecting yourself from HPV infection.^2,3

If you are a smoker, you can greatly decrease your risk if you quit smoking. You may think that quitting is easier said than done, but there are many resources available to help you. To further decrease your risk, you should stop using all tobacco products and avoid alcohol.⁵

HPV is the most common STI. The HPV vaccine can help protect you from HPV infections that have the potential to cause cancer. If you have not been vaccinated, speak with your healthcare provider to determine if the HPV vaccine is right for you. Because HPV is an STI, having protected sex and limiting your number of sexual partners can also help lower your risk of infection.^2,3

Symptoms of Head and Neck Cancer

Being able to recognize the signs and symptoms of head and neck cancer is an important part of raising awareness. The symptoms associated with head and neck cancer can be easily mistaken as symptoms of other conditions.^3,5

Symptoms include:

• White or red patches in the mouth, including the gums or tongue
• Pain in the neck or throat that does not go away
• A lump or hard area with or without pain
• Sore throat or pain when swallowing
• Chronic sinus infections
• Voice changes
• Nosebleeds

If you are experiencing signs and symptoms, discuss your concerns with your healthcare team, especially if you are at higher risk.

Help Raise Awareness

The Black community has historically been underrepresented in clinical trials across many areas of disease research. The harsh reality is that treatment and outcome disparities along racial divides exist among people with head and neck cancers.⁶ Minorities represent close to 40% of the United States population but only 11% of participants in clinical trials for FDA approved cancer drugs in 2020 were Black or Hispanic. Further research may help to understand exactly why. Still, in the meantime, it is important that we work to raise awareness of this lack of representation by increasing the participation of Black, Indigenous, and People of Color (BIPOC) in clinical research. Doing so will help ensure that future research and treatment advances incorporate study data from minority participants and apply to patients within these communities.

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References:

1. Squamous Cell Skin Cancer
2. Penn Medicine. Squamous Cell Carcinoma of the Head and Neck
3. National Cancer Institute. Head and Neck Cancers
4. Liu, J. C., et al. “Racial survival disparities in head and neck cancer clinical trials.” Journal of the National Cancer Institute (2022): djac219-djac219.
5. American Society of Clinical Oncology. Head and Neck Cancer
6. Washington University School of Medicine in St. Louis. Gender and race interaction revealed in cancer survival disparities.

American Society of Clinical Oncology. Addressing the Barriers to Minority Participation in Cancer Clinical Trials