Oral cavity cancer in young, non-smoking, and non-drinking patients: A contemporary review

Crit Rev Oncol Hematol. 2023 Oct:190:104112. doi: 10.1016/j.critrevonc.2023.104112. Epub 2023 Aug 24.


Oral squamous cell carcinoma (OSCC) in non-smoking and non-drinking (NSND) individuals appears to be distinct from the traditional head and neck squamous cell carcinoma (HNSCC). The incidence of this subset is increasing, as are the number of studies examining its characteristics. NSND OSCC individuals tend to be younger (<45 years) compared to traditional HNSCC patients. The proportion of females in the NSND OSCC cohort is also higher. The tongue is the predominantly affected subsite. Studies have revealed several gene mutations and unique epigenomic profiles but no definitive genetic etiology. Transcriptomic analysis has not found any causative viral agents. Other proposed etiologies include chronic dental trauma, microbiome abnormalities, marijuana consumption, and genetic disorders. There are international efforts to determine the relative prognostic outcome of this unique cohort, but no consensus has been reached. Here, we review the incidence, demographics, subsite, possible etiologies, prognosis, and therapy implications of the NSND OSCC cohort.

Keywords: Head and neck cancer; Non-drinkers; Non-smokers; Oral cancer; Young.

Publication types

  • Review

MeSH terms

  • Carcinoma, Squamous Cell*
  • Female
  • Head and Neck Neoplasms*
  • Humans
  • Mouth Neoplasms* / diagnosis
  • Mouth Neoplasms* / epidemiology
  • Mouth Neoplasms* / etiology
  • Squamous Cell Carcinoma of Head and Neck / epidemiology
  • Squamous Cell Carcinoma of Head and Neck / etiology
  • Squamous Cell Carcinoma of Head and Neck / therapy