Oral squamous cell carcinoma in non-smoking women: Systematic literature review illustrated with 10 clinical cases diagnosed in a 12-month period

Abstract

Introduction: Oral squamous cell carcinoma (OSCC) is one of the most common malignant neoplasms in the head and neck region, accounting for up to 95% of cases. Traditionally associated with tobacco and alcohol consumption, recent studies have highlighted an increase in incidence in non-smoking and non-alcohol-drinking women, with etiologies and risk factors not yet fully understood. Objective: To conduct a systematic review of the literature on oral squamous cell carcinoma in non-smoking and non-alcoholic women, illustrating the findings with the presentation of ten clinical cases diagnosed in a private center in the city of Goiânia. Materials and Methods: A systematic search was performed in the Brazilian Virtual Health Library (BVS), CAPES, PubMed and SciELO databases, covering studies published between 2000 and 2024. Articles that addressed OSCC in non-smoking women, available in Portuguese, English or Spanish, were included, totaling 16 articles after applying the inclusion and exclusion criteria. Ten clinical cases of patients diagnosed between 2023 and 2024 were reviewed and compared to the literature. Results: The literature review revealed the increasing incidence of SCC in women with no history of smoking or alcoholism, with a predominance of lesions on the tongue and an increase in cases among younger patients. The ten clinical cases studied showed ulcerated lesions and nodules in various regions of the oral cavity, and the patients ranged in age from 35 to 79 years. Comorbidities such as hypertension and diabetes were present in some cases, influencing the prognosis and choice of treatment. The treatments adopted included surgery, radiotherapy, and chemotherapy, and three patients died during follow-up. Conclusion: Oral squamous cell carcinoma in nonsmoking women is a condition that challenges the traditional understanding of risk factors. Although smoking and alcohol are not present as primary causes in these cases, other factors, such as viral infections (HPV), genetic predispositions, and comorbidities, should be considered. This study highlights the need for early diagnosis and further research into the possible etiologies of this neoplasia in populations not exposed to classical risk factors