The combined effects of alcohol and tobacco on overall health with a focus on oral and pharyngeal cancer
Flynn, Richard E.
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Oral and pharyngeal cancer (OPC) is the sixth most common type of cancer globally and is becoming more frequent in younger populations (age 45 and below). The two main factors influencing a person's risk for OPC involve the individual's pattern of alcohol and tobacco consumption. Alcohol and tobacco are each associated with their own risk factors and morbidities, but when combined together the risk for OPC multiplies significantly. The combined consumption of alcohol and tobacco has detrimental effects on oral health, OPC being the most severe. Generally OPC is rare among younger individuals and tends to develop when people are greater than 60 yrs old. This new pattern of emerging OPC in younger individuals raises the question of whether or not the two age groups are exposed to common risk factors increasing the risk of early and more severe cases of OPC. The current study will examine the pathogenesis and genetic pathways that are causative agents for OPC. Additionally, this paper aims to determine the direct pathogenesis that is involved individually with alcohol and tobacco products. Specifically we seek to determine the pathogenic effects when alcohol and tobacco are used in combination. In conclusion, the findings of the study indicated that the two substances (alcohol and tobacco) have very similar effects at the molecular level. The effects that each exert involve the accumulation of DNA damage over time. Yet the exact pathogenic mechanism in which each substance affects the cellular function when combined is unknown. The theorized molecular mechanism involves alcohol increasing the permeability of the oral mucosa allowing tobacco carcinogens greater access into the tissue. Hence alcohol is a multiplying factor that increases the detrimental effects of tobacco. In conclusion the combined use of alcohol and tobacco greatly increases the chances of developing OPC in younger populations. By improving outreach and education of the public on the cumulative effects of tobacco and alcohol, especially at the high school and college level, a change in usage can hopefully be brought about leading decreased OPC in all populations.
Thesis (M.A.)--Boston University