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Laryngology/Broncho-Esophagology

(187) Evolving Association Between Tobacco Use and Glottic Squamous Cell Carcinoma

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • Bharat A. Panuganti, MD

    Assistant Professor
    The University of Alabama at Birmingham, Department of Otolaryngology
    Birmingham, Alabama, United States

  • Steven M. Zeitels, MD

    Eugene B. Casey Professor & Chief: Division of Laryngeal Surgery
    Harvard Medical School & Massachusetts General Hospital
    Boston, Massachusetts, United States

Disclosure(s):
Bharat A. Panuganti, MD: No relevant relationships to disclose.
Steven M. Zeitels, MD: No relevant relationships to disclose.


Introduction: Glottic squamous cell carcinoma has historically had a stringent association with former and/or active smoked tobacco use. Recent studies meant to investigate the incidence of p16 positivity and oncogenic HPV DNA in laryngeal cancer specimens have stipulated an alternative etiology in a subset of cases. We aimed to determine an updated prevalence of non-smokers among patients diagnosed with glottic cancer contingent on a single-institution’s experience.

Methods: Patients diagnosed with glottic squamous cell carcinoma at the authors’ institution were identified based on retrospective chart review. Smoking status (never versus current/former smoker), treatment modality, TNM tumor staging, and recurrence data, in addition to standard clinicodemographic information, were recorded. Discrete timeframes were defined (2004-2009, 2010-2015, 2016-2022) to analyze temporal changes in patient smoking status.

Results: Study included 464 patients diagnosed between 2004-2022 with glottic cancer and with known smoking history. Total of 125 patients (26.94%) of patients were non-smokers. No significant association was identified between smoking status and T classification (p=0.31), year of diagnosis (p=0.2), gender (p=0.13), and reflux history (0.94). Non-smokers with glottic cancer were diagnosed at a younger age (61.88 vs. 64.84 years, p=0.024).

Conclusions: A significant proportion (26.94%) of glottic cancer patients were non-smokers; most hallmark clinicodemographic features were similar between non-smokers and current/former smokers. These findings should be considered carefully by clinicians when considering the probability of underlying malignancy among patients with laryngeal complaints and bolster future investigations to identify the precise role of HPV in glottic carcinogenesis.