Oral cancer and tobacco: a case control study in southern India
Keywords:Oral cancer, Tobacco, Case control study
Background: Cancer is one of the major threats to public health in the developed world and increasingly in the developing world. In India, oral cancer is the leading cancer in males and ranking third in females. The risk factors for the development of oral cancers include tobacco smoking.
Methods: A Case control study done at Kidwai Memorial Institute of Oncology, Bangalore, India. Study subjects included histological confirmed new cases of oral cancer attending the hospital during the period of April 2014- May 2015 and equal number of age and sex matched controls. Data collection was done by interview method.
Results: Tobacco smoking with an odds ratio (OR) of 3.5 was significantly associated with the risk of oral cancer. The OR was 4.1 for combined bidi plus cigarette smokers and 3.7 for bidi smokers compared to non smokers. The OR was 2.3 for those who smoked less than or equal to 20 bidis/cigarettes per day and 8.3 for those who smoked more than 20 bidis/cigarettes per day, compared to non smokers. Smokers with pack years less than or equal to 20 showed 2.3 times, those with pack years 21- 29 showed 5.9 times and those with pack years more than 30 years showed 9.4 times higher risk for oral cancer compared to non smokers.
Conclusions: Tobacco smoking shows higher risk for oral cancer. There is a great need to augment tobacco control measures and educate the public about harmful effects of tobacco consumption.
Park K. Text book of Preventive and Social Medicine. Epidemiology of chronic non communicable diseases and conditions. 22nd ed. Jabalpur; M/S Banarsidas Bhanot publishers; 2013: 352-362.
Peterson PE, Community Dentistry Oral Epidemiology, The WHO perspective: Strengthening the Prevention of Oral Cancer, Blackwell Munksguard. 2005;33(6):397-9.
WHO Media centre, Global burden of cancer. Available at: http://www.who.int/mediacentre/ factsheets/fs 297/en/. Accessed on 15 April 2015.
Stewart BW, Kleives.P, World Cancer Report Lyon, WHO International Agency for Research on Cancer, 2003.
Ferlay J, Bray F, Pisani P, Parkin DM, GLOBACON 2002: Cancer incidence, mortality and prevalence worldwide. IARC Cancer Base. Lyon: IARC Press. 2004;5;2.
Hiremath SS, Text book of Preventive and Community Dentistry, New Delhi; Elsevier, a division of Reed Elsevier India pvt. Ltd; 2007: 138- 142.
Oral cancer- Wikipedia, the free encyclopedia. Available at: http://en.wikipedia.org/wiki/Oral_ cancer. Accessed on 08 May 2015.
Peter S. Essentials of preventive and community dentistry, 3rd edition. New Delhi: Arya Publishing House; 2007: 452-487.
Garrote LF, Herrero R, Reyes RO, Vaccarella S, Anta LJ, Ferbeye L, et al. Risk factors for cancer of the oral cavity and oro- pharynx in Cuba. Br J Cancer. 2001;85(1):46-54.
Muwonge R, Ramdas K, Sankila R, Thara S, Thomas G, Vinoda J, et al. Role of tobacco smoking, chewing and alcohol drinking in the risk of oral cancer in Trivandrum, India: A nested case control design using incident cancer cases. Oral Oncol. 2008;44:446-54.
Balaram P, Sridhar H, Rajkumar T, Vaccarella S, Herrero R, Nandakumar A, et al, Oral cancer in Southern India: The influence of smoking, drinking, paan chewing and oral hygiene. Int J Cancer. 2002;98:440-5.
Sankarnarayanan R, Duffy SW, Day NE, Nair M.K, Padmakumary G. A case control investigation of cancer of the oral tongue and the floor of the mouth in Southern India. Int J Cancer. 1989;44:617-21.
Gajalakshmi V. Tobacco use and risk of oral cancer in south India. UICC World Cancer Congress. 2006: 8-12.