Tongue carcinoma in young adults : a review of the literature

A recent reduction in the number of smoke-related tumours has been observed thanks to the diffusion of anti-tobacco campaigns carried
out in the majority of developed countries. Nevertheless, as demonstrated by recent global epidemiologic studies, squamous cell carcinoma
of the mobile tongue appears to be progressively increasing in incidence, particularly among young adults and especially in females. The
driving mechanism responsible for such changes is still to be precisely defined. Several genetic studies have compared the mutational pattern of tongue squamous cell carcinoma in young adults to that of more elderly patients, without identifying significant differences that may
help in better characterising this subgroup of subjects. Tongue squamous cell carcinomas in young adults have been historically considered
as particularly aggressive clinical entities, with a high risk of loco-regional relapse, survival rates inferior to those of the general head and
neck cancer group and need for a more aggressive therapy. However, considering the most recent studies, prognostic results in this patient
group are heterogeneous and it is not possible to confirm this tendency. Thus, it is not justified to embrace different therapeutic approaches
according to patient age. Eventually, an additional element to consider when examining young subjects affected by tongue cancer is the
possibility of genetic predisposition. Alterations affecting pathways involved in DNA repair, surveillance of genetic stability or regulation
of cellular growth may determine an increased likelihood of developing head and neck cancers.