Clinicopathological characteristics of head and neck squamous cell carcinomas in adolescents and young adults: A retrospective hospital-based study from northeast India.
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BACKGROUND: The incidence of head and neck cancer, excluding nasopharyngeal cancer, has been increasing. The majority of the risk factors in these young adults, however, remain unknown. Prognosis, on the other hand, is similar when compared to that in the older age group. There are limited data available for the same. Hence, we undertook this retrospective study to evaluate the clinicopathological characteristics in head and neck squamous cell carcinoma among young adults aged 15-39 years in Manipur, India. METHOD: Retrospective data were collected of histologically proven Head and neck squamous cell carcinoma in an adolescent and young adult (AYA) cohort aged 15-39 years ( n = 154) treated at the Department of Radiation Oncology, Regional Cancer Centre, Imphal, Manipur, India, from 2019 to 2023. Patient data such as age at diagnosis, sex, sequential order of cancer incidence, histological type and grade, primary site of cancer, treatment received and follow-up were collected. Patients with nonsquamous cell histology, recurrent disease at presentation, metachronous cancers, incomplete medical records and patients who defaulted treatment were excluded from the study. RESULT: The mean age of the study population was 34.18 ± 4.69 years, with a male predominance (60.4%). The tongue (31.1%) and buccal mucosa (23.4%) were the most common primary tumor sites. Moderately differentiated (Grade 2) tumors constituted 57.8% of cases. Most patients presented with advanced disease, with Stage IVA (39.0%) and Stage III (36.4%) accounting for the majority of cases. Conventional risk factors were not documented in 87.7% of patients. During follow-up, locoregional recurrence occurred in 16 patients (10.4%), while distant metastasis was observed in one patient (0.6%). CONCLUSION: Head and neck squamous cell carcinomas in AYA patients from Northeast India predominantly involve the oral cavity and frequently present at an advanced stage. The high proportion of patients without documented conventional risk factors highlights the need for further prospective studies evaluating environmental, lifestyle, and molecular determinants. Strategies promoting earlier diagnosis and timely referral may improve outcomes in this young patient population.