To the Editor.
—Reports have appeared in the literature regarding the increased mortality from tongue cancer among young adults in the United States.1,2 Shemen et al1 showed that an increase in head and neck cancer began in the mid-1970s and principally involved men younger than 40 years old. In light of the growing prevalence of the use of smokeless tobacco among the young adult population,3 Depue2 suggested a causal relationship between these two trends, but, as yet, direct evidence to support the relationship has not been provided.A review of the patient registry of The University of Texas M. D. Anderson Hospital and Tumor Institute between 1944 and 1984 also has revealed a significant increase in squamous cell carcinoma of the tongue among young adults (younger than age 40 years) (Table). The increase is both in absolute numbers and in the percentage of the total number
Stimson P. Schantz, Robert M. Byers, Helmuth Goepfert. Tobacco and Cancer of the Tongue in Young Adults. JAMA. 1988;259(13):1943–1944. doi:10.1001/jama.1988.03720130021012