Applications of molecular epidemiology to head and neck cancer

Cancer may be viewed as a genetic disease characterized by the failure of cellular mechanisms to maintain genomic integrity. Molecular progression models defining genetic damage are being developed for a number of solid tumors including head and neck squamous cell carcinoma. Genetic alteration of certain classes of genes, the tumor suppressor genes and proto-oncogenes, seem to be common events in such models. Host modulation of environmental carcinogens, however, also may be an important disease determinant. Interindividual differences in susceptibility to the genotoxic effects of environmental carcinogens may be genetically determined. With technologic advances in molecular genetics, it is now possible to identify specific genetic alterations that occur in different stages of neoplasia. Correlation of these genetic alterations with susceptibility models for solid tumors has important implications for the field of molecular epidemiology.