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Purpose Poor oral health is associated with head and neck cancer (HNC). We evaluated whether a national oral health screening program (OHSP) could reduce the risk of HNC. Materials and Methods Data from 408,247 healthy individuals aged ≥ 40 years from the National Health Insurance System-National Health Screening program during 2003 and 2004 in Korea were analyzed. The risk of HNC was compared between subjects who underwent OHSP (HEALS-Dental+, n=165,292) and routine health check-ups only (HEALS-Dental–, n=242,955). The impact of individual oral health-related factors on HNC risk was evaluated in HEALS-Dental+. Results A total of 1,650 HNC cases were diagnosed. The 10-year HNC-free rate was 99.684% with a median follow-up of 11 years. The risk of all HNC (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.03 to 1.29; p=0.011) and oropharyngeal cancer (HR, 1.48; 95% CI, 1.13 to 1.94; p=0.005) was significantly higher in HEALS-Dental– than in HEALS-Dental+. In HEALS-Dental+, oral cavity cancer was marginally reduced (p=0.085), and missing teeth was a significant factor for HNC (HR, 1.24; 95% CI, 1.02 to 1.50; p=0.032). Toothbrushing was a significant factor in univariate analysis (p=0.028), but not in multivariate analysis (p=0.877). Conclusion The National OHSP significantly reduced the long-term HNC risk, particularly the incidence of oropharyngeal cancer. Routine OHSP should be considered at the population level. [ABSTRACT FROM AUTHOR]

Purpose: Studies on de-escalation in radiation therapy (RT) for human papillomavirus-positive (HPV(+)) oropharyngeal cancer (OPC) are currently ongoing. This study investigated the current practice regarding the radiation dose and field in the treatment of HPV(+) OPC. Materials and Methods: The Korean Society for Head and Neck Oncology conducted a questionnaire on the primary treatment policy. Among them, for HPV(+) OPC scenarios, radiation oncologists were questioned regarding the field and dose of RT. Results: Forty-two radiation oncologists responded to the survey. In definitive concurrent chemoradiotherapy (CCRT) treatment for stage T2N1M0 OPC, most respondents prescribed a dose of >60 Gy to the primary tonsil and involved ipsilateral lymph nodes. However, eight of the respondents prescribed a relatively low dose of =54 Gy. For stage T2N1M0 OPC, postoperative adjuvant RT was prescribed by eight and nine respondents with a lower dose of =50 Gy for the ipsilateral tonsil and involved neck, respectively. In definitive CCRT in complete remission after induction chemotherapy for initial stage T2N3M0 OPC, de-escalation of the tonsil and involved neck were performed by eight and seven respondents, respectively. Regarding whether de-escalation is applied in radiotherapy for HPV(+) OPC, 27 (64.3%) did not do it at present, and 15 (35.7%) were doing or considering it. Conclusion: The field and dose of prescribed treatment varied between institutions in Korea. Among them, dose de-escalation of RT in HPV(+) OPC was observed in approximately 20% of the respondents. Consensus guidelines will be set in the near future after the completion of ongoing prospective trials. [ABSTRACT FROM AUTHOR]

Objectives: The present study evaluated the associations between gastroesophageal reflux disease (GERD) and head and neck cancer using a national sample cohort of the Korean population. Design: We designed two studies using data collected from patients aged ≥40 years in the Korean National Health Insurance Service‐National Sample Cohort from 2002 to 2013. Main outcome Measures: Study I included participants with GERD matched 1:2 with controls and analysed the incidences of lip and oral cavity, oropharynx, hypopharynx and larynx cancers. Study II included participants with larynx cancer matched 1:4 with controls and analysed the previous histories of GERD. Head and neck cancer was identified using medical claim codes for surgical, radiation and chemotherapeutic treatments and death records from the National Statistical Office. Crude and adjusted hazard ratios (HRs) were analysed using the Cox proportional hazard model. Crude and adjusted odds ratios (ORs) were analysed using unconditional logistic regression analyses. Subgroup analyses were performed on groups stratified by age and sex. Results: The adjusted HR for larynx cancer was 2.32 (95% confidence interval (CI) = 1.53‐3.52, P < 0.001) in the GERD group. However, the HRs for lip and oral cavity cancer, oropharynx cancer and hypopharynx cancer were not statistically significant (study I). The adjusted OR for GERD was 2.03 (95% CI = 1.40‐2.96, P < 0.001) in the larynx cancer group; consistent results were obtained in subgroup analyses. Conclusion: Gastroesophageal reflux disease increases the risk of larynx cancer. [ABSTRACT FROM AUTHOR]