All ETDs from UAB

School

School of Public Health

Document Type

Dissertation

Department (new version)

Public Health

Date of Award

1993

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

Salivary gland tumors are uncommon, and their epidemiology has not been well described. A descriptive epidemiologic study of major (parotid, submaxillary, and sublingual) salivary gland tumors newly diagnosed in Jefferson County, Alabama hospitals from 1968-1989 was conducted. Medical records were reviewed and data on numerous factors of possible etiologic importance were abstracted. Incidence rates were estimated using a population based subset of cases (incidence series). Six hundred eighty-two cases of salivary gland tumors were identified, of which 149 were Warthin's tumors. Warthin's tumor was found to be strongly associated with cigarette smoking. Using other tumors as a control group, the relative incidence (RI) of Warthin's tumor among smokers vs. non-smokers was 7.6 for males and 17.4 for females; both RIs were highly significant (P $<$ 0.001). Smokers with Warthin's tumors also smoked more heavily than those with other tumors (P $<$ 0.001). From 1968 through 1988, Warthin's tumors steadily increased in number and as a proportion of all tumors (males, P = 0.003; females, P = 0.008). The incidence series comprised 248 cases, of which 84.3% were benign and 15.7% were malignant. Eighty-six percent of cases arose in the parotid gland and 14% in the submaxillary gland. No sublingual gland tumor was identified. The benign mixed tumor was the most frequent benign tumor (65.6%), followed by Warthin's tumor (29.2%). Mucoepidermoid carcinoma was the most frequent malignant tumor (51.3%). The average annual age-adjusted incidence rate per 100,000 was 4.7 for benign tumors and 0.9 for malignant tumors. Incidence rates for both benign and malignant tumors increased with age until ages 65-74, then declined. The male:female incidence rate ratio (IRR) was 0.6 for benign mixed tumors, 2.3 for Warthin's tumors, and 3.5 for malignant tumors; 95% confidence intervals for each IRR excluded the null. Warthin's tumor was rare in blacks; the white:black IRR for this tumor was 13.0 (95% confidence interval, 3.2 to 16.0; P $ <$ 0.001). From 1979 to 1988, the incidence rate for Warthin's tumor significantly increased (P = 0.046), while no change was observed for other tumor types. Using local blood donors as controls, no association was observed between ABO blood groups and 200 salivary gland tumor cases with known blood type.

ProQuest Publication Number

Document on ProQuest

ProQuest ID

9329556

ISBN

979-8-208-85644-4

Comments

DrPH

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