Background: The risk factors and disease behavior are not the same in young and elderly oral cancer patients.

Aim:To compare the clinical profile, smoking habits and biologic behavior of oral cavity cancers in the young and elderly patients.

Methods:Gender distribution, site of oral cavity cancer, stage at presentation, smoking habits, treatment modality employed, compliance to treatment, response rates and toxicity profiles were analyzed and compared for oral cancer patients less than 40 years of age and more than 65 years of age. 31 younger patients and 33 elderly patients were identified between the year 2012 and 2013.

Results:Cancer of Buccal mucosa was the most common site involved in younger patients (58%) whereas carcinoma of alveolus was commonly found in elderly patients (39%). There were more female patients in the elderly age group when compared to younger population (42% Vs 19%). Smokeless tobacco usage was common in the younger patients(87%) whereas cigarette smoking(66.7%) was common in the elderly. Younger patients had shorter duration of symptoms( median 3 months Vs 7 months respectively) and more advanced T stage and N stage at presentation compared to elderly patients. More than 80% of patients in both the groups were treated with chemoradiation. The disease was found to be aggressive in younger patients with poor response rates (38% Vs 85% respectively) and rapid progression rates(58% Vs 9%respectively) when compared to elderly population. Grade 3 toxicity was more commonly seen in elderly patients than younger patients.( 75.5% Vs 48% respectively)

Conclusions:This study reveals an inherently aggressive disease in young patients with oral cancers. Further research to analyze the genetic profile of these younger patients is needed. More aggressive treatment may benefit these patients.