Abstract
Tobacco and betel quid are the most common cause of oral cancer in India. Very often oral cancers are preceded by a visible oral precursor lesion called as potentially malignant disorder (PMD). Aim: The aim of this study was to assess the prevalence of oral PMDs associated with habits in urban and rural areas of Puducherry Union territory, India. Methods: A cross-sectional descriptive study in urban and rural areas of Puducherry was conducted. The study group comprised of 450 patients with positive history of oral habits. A standard structured questionnaire was designed to record information about demographic details, socioeconomic status, type, duration and frequency of habits followed by clinical oral examination by single trained and calibrated examiner to detect the presence of PMD. Statistical analysis used: EpiData software (version 3.1). Descriptive statistics were presented for all variables. Pearson’s Chi-Square test and adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated to estimate the suspected risk factors for PMD by using multivariate logistic regression analysis. P-value of ≤ 0.05 was considered to be statistically significant. Results: Prevalence of habit associated oral PMD was 64.2%. Females were more prone to develop PMDs (68.3%) as compared to males (62.8%). PMD was more common in the age group of 51-60 years (69.2%). Smoking with alcohol consumption was the most common oral habit. Habits, socio-economic status and diet were significantly associated with development of oral PMDs in our study population. Multivariate logistic regression analysis showed that chronic betel quid chewing and smoking were significant risk factors for PMD. Increased frequency of vegetable consumption reduced the risk of PMD. Conclusions: Oral PMD were observed in more than half of the subjects with oral habits in Puducherry. Clearly, there is an increased risk of PMD with increased duration of tobacco and betel quid use in this region. Patients and public need to be educated regarding PMD and encouraged to quit habits so as to prevent high risk population from developing cancer.
References
2. Warnakulasuriya S. Clinical features and presentation of oral potentially malignant disorders. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Jun;125(6):582-590. doi: 10.1016/j.oooo.2018.03.011.
3. Mello FW, Miguel AFP, Dutra KL, Porporatti AL, Warnakulasuriya S, Guerra ENS, et al. Prevalence of oral potentially malignant disorders: a systematic review and meta-analysis. J Oral Pathol Med. 2018 Aug;47(7):633-640. doi: 10.1111/jop.12726.
4. Bhardwaj N, Daniel MJ, Srinivasan SV, Jimsha VK. Demographics, habits, and clinical presentation of oral cancer in Puducherry’s population: An institutional experience. J Indian Acad Dent Spec Res. 2015;2(2):64-9. doi: 10.4103/2229-3019.177926.
5. Gupta S, Singh R, Gupta OP, Tripathi A. Prevalence of oral cancer and pre-cancerous lesions and the association with numerous risk factors in North India: A hospital based study. Natl J Maxillofac Surg. 2014 Jul-Dec;5(2):142-8. doi: 10.4103/0975-5950.154816.
6. Saraswathi TR1, Ranganathan K, Shanmugam S, Sowmya R, Narasimhan PD, Gunaseelan R. Prevalence of oral lesions in relation to habits: Cross-sectional study in South India. Indian J Dent Res. 2006 Jul-Sep;17(3):121-5.
7. Vinay BH, Baghirath PV, Kumar JV, Arvind. Prevalence of precancerous lesions and conditions in Telangana region, Andhra Pradesh, India. J Indian Assoc Public Health Dent. 2014;12(1):23-7. doi : 10.4103/2319-5932.138904.
8. Thada SR, Pai KM. Prevalence of habit associated oral mucosal lesions among the outpatients - A prospective cross sectional study. Int J Res Health Sci. 2014 Jan31;2(1):263-73.
9. Narasannavar A,Wantamuttet A. Prevalence of oral precancerous lesions and conditions among tobacco consumers in rural population around Belgaum. A community based cross sectional study. IOSR J Dent Med Sci. 2014 Apr;13(4):31-4. doi: 10.9790/0853-13433134.
10. Jagtap SV, Warhate P, Saini N, Jagtap SS, Chougule PG. Oral premalignant lesions: a clinicopathological study. Int Surg J. 2017;4(10):3477-81. doi: 10.18203/2349-2902.isj20174520.
11. Hosagadde S, Dabholkar J, Virmani N. A clinicopathological study of oral potentially malignant disorders. J Head Neck Physicians Surg. 2016;4(1):29 34. doi: 10.4103/2347-8128.182853.
12. Kumar S, Debnath N, Ismail MB, Kumar A, Kumar A, Badiyani BK, et al. Prevalence and Risk Factors for Oral Potentially Malignant Disorders in Indian Population. Adv Prev Med. 2015;2015:208519. doi: 10.1155/2015/208519.
13. Aroquiadasse M, Daniel MJ, Srinivasan SV, Jimsha VK. Correlation of degree of dysplasia in potentially malignant disorders with tobacco use: A cross-sectional study. Clin Cancer Investig J. 2016;5(5):398-402. doi: 10.4103/2278-0513.197870.
14. Easwaran M, BazroyJ, Jayaseelan V, Singh Z. Prevalence and determinants of alcohol consumption among adult men in a coastal area of South India. Int J Med Sci Public Health 2015;4(3):360-4. doi: 10.5455/ijmsph.2015.1010201479.
15. Ariyawardana A, Sitheeque MA, Ranasinghe AW, Perera I, Tilakaratne WM, Amaratunga EA, et al. Prevalence of oral cancer, pre cancer and associated risk factors among tea estate workers in the central Sri Lanka. J Oral Pathol Med. 2007 Nov;36(10):581-7.
16. Hashibe M, Mathew B, Kuruvilla B, Thomas G, Sankaranarayanan R, Parkin DM, et al. Chewing tobacco, alcohol, and the risk of erythroplakia. Cancer Epidemiol Biomarkers Prev. 2000 Jul;9(7):639-45.
17. Sawyer DR, Wood NK. Oral cancer: Etiology, recognition and management. Dent Clin North Am. 1992 Oct;36(4):919-44.
18. Marija, Bratic B, Vuckovic N. Cigarette Smoking as a risk factor associated with oral leukoplakia. Arch Oncol. 2002;10(2):67-70. doi: 10.2298/AOO0202067B.
19. Baric JM, Alman JE, Feldman RS, Chauncey HH. Influence of cigarette, pipe and cigar smoking, removable partial dentures and age on oral leukoplakia. Oral Surg Oral Med Oral Pathol. 1982 Oct;54(4):424-9.
20. Zain RB, Ikeda N, Gupta PC, Warnakulasuriya S, van Wyk CW, Shrestha P, et al. Oral mucosal lesions associated with betel quid, areca nut and tobacco chewing habits: consensus from a workshop held in Kuala Lumpur, Malaysia, November 25-27, 1996. J Oral Pathol Med. 1999 Jan;28(1):1-4.
21. Sankaranarayanan R, Duffy SW, Padmakumary G, Day NE, Krishan Nair M. Risk factors for cancer of buccal and labial mucosa in Kerala, Southern India. J Epidemiol Community Health. 1990 Dec;44(4):286-92.
22. Macigo FG, Mwaniki DL, Guthua SW. The association between oral leukoplakia and use of tobacco, alcohol and Khat based on relative risks assessment in Kenya. Eur J Oral Sci. 1995 Oct;103(5):268-73.
23. Thavarajah R, Rao A, Raman U, Rajasekaran ST, Joshua E, Hemalatha R, et.al. Oral lesions of 500 habitual psychoactive substance users in Chennai, India. Arch Oral Biol. 2006 Jun;51(6):512-9.
24. Mathew AL, Daniel MP, Cherian SA. Prevalence of oral precancer and cancer in south kerala population. J. Oral Diag. 2017;02:e20170036. doi: 10.5935/2525-5711.20170036.
25. Mortazavi H, Baharvand M, Mehdipour M. Oral Potentially Malignant Disorders: An Overview of More than 20 Entities. J Dent Res Dent Clin Dent Prospects. 2014 Winter;8(1):6-14. doi: 10.5681/joddd.2014.002.
26. Allen A, Williams J, Townsend N, Mikkelsen B, Roberts N, Foster C, et al. Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: A systematic review. Lancet Glob Health. 2017 Mar;5(3):e277-e289. doi: 10.1016/S2214-109X(17)30058-X.
27. Vikneshan M, Ankola AV, Hebbal M, Sharma R, Suganya M. Patterns of tobacco usage and oral mucosal lesions of industrial workers: a cross sectional study. Austin J Public Health Epidemiol. 2016;3(1):1029.
28. Pahwa V,Nair S,Shetty RS, Kamath A. Prevalence of Oral Premalignant Lesions and Its Risk Factors among the Adult Population in Udupi Taluk of Coastal Karnataka, India. Asian Pac J Cancer Prev. 2018 Aug 24;19(8):2165-70.
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