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In the early 1970s, persistent smoking was thought to be the predominant cause of HNSCC. Over the years, tobacco research has focused on the identification of the principal carcinogens, potential routes of exposure, and the mechanisms by which tobacco products cause cancer. T-2 toxin was discovered to be a potent in vitro and in vivo carcinogen that induces a variety of human lung cancers. However, it was not until the 1980s, when studies at the National Cancer Institute (NCI) showed that consumption of a diet high in nitrosamines greatly increased the risk of oral leukoplakia, a premalignant lesion of the oral mucosa, that a link between tobacco and HNSCC was suggested. The first of these studies compared the rates of HNSCC in rural and urban populations in Taiwan. For adults over 50 years of age, the rates of HNSCC in rural Taiwan were about 1.5-fold higher than in urban areas. While the numbers of HNSCC cases were quite small (37 and 30), this difference was statistically significant. Another study evaluated the rates of HNSCC among patients from a defined area of Maine and compared them with those from an area of New Hampshire. This analysis showed a 3.7-fold increase in HNSCC among former and current smokers and a threefold increase in oral cavity, oropharynx and larynx cancers. The number of HNSCC cases was also quite small (53 cases).
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One of the drawbacks to this approach was that we needed to recompile every time we made even a small change to the code. This slowed everything else we were doing down and because we couldn't always have someone waiting for the application to finish building. 827ec27edc