Lifestyle risk factors for oral cancer

Habits with killer instincts: in vivo analysis on the severity of oral mucosal alterations using autofluorescence spectroscopy

Oral habits like chewing and smoking are main causes of oral cancer, which has a higher mortality rate than many other cancer forms. Currently, the long term survival rate of oral cancer is less than 50%, as a majority of cases are detected very late. The clinician's main challenge is to differentiate among a multitude of red, white, or ulcerated lesions. Hence, new noninvasive, reliable, and fast techniques for the discrimination of oral cavity disorders are to be developed. This study includes autofluorescence spectroscopic screening of normal volunteers with and without lifestyle oral habits and patients with oral submucous fibrosis (OSF). The spectra from different sites of habitués, non-habitués, and OSF patients were analyzed using the intensity ratio, redox ratio, and linear discriminant analysis (LDA). The spectral disparities among these groups are well demonstrated in the emission regions of collagen and Flavin adenine dinucleotide. We observed that LDA gives better efficiency of classification than the intensity ratio technique. Even the differentiation of habitués and non-habitués could be well established with LDA. The study concludes that the clinical application of autofluorescence spectroscopy along with LDA, yields spontaneous screening among individuals, facilitating better patient management for clinicians and better quality of life for patients.

Should Red Wine Be Considered a Functional Food?

  Functional foods may be regarded as foods that have nutritional value, but in particular, they also have beneficial effects on one or more body functions. Thus, functional foods may improve health and/or reduce the risk of developing certain diseases when taken in amounts that can be consumed in a normal diet. Based on nearly 2 decades of research since the term "French paradox" was first coined in 1992, wine would appear to fit this definition. Yet there seems to be reluctance to consider wine as a functional food. In this review, we present an overview of the accumulated evidence for the health benefits of wine-and its key phenolic components such as resveratrol, quercetin, catechin-and show that these alone are not enough to firmly establish wine as a functional food. What is required is to create clearly defined products based on wine that are targeted to consumers' needs and expectations when it comes to purchasing functional foods. Moreover, the crucial question of alcohol and health also needs to be addressed by the functional food industry. Suggestions are presented for working through this issue, but in many regards, wine is like any other food-it should be consumed sensibly and in amounts that are beneficial to health. Overindulgence of any kind does not promote good health.

Lifestyle: Bioethics at a Critical Juncture

More than ever, the way we live our lives has become subject to our own decisionmaking. Our whole way of living, in particular what we do to our body, has become the expression of personal lifestyle choices. Because we can make changes to our body according to our own individual preferences, every aspect of our life begins to be seen as the result of individual and voluntary decisions. The comparison with advertising is pertinent here: we should no longer accept the way we are but can choose from a variety of options. Go to any supermarket and look around: innumerable products are promoted because of their healthy ingredients, whether to lower our cholesterol or heighten our natural resistance. And, of course, we buy what is on offer.

Dietary consumption practices and cancer risk in African Americans in the rural South

This study describes the dietary consumption practices of a sample of African Americans in the rural South. A qualitative research design involving a cross-sectional food diary was utilized. Complete datasets were collected from 114 participants, 66% female, between the ages of 19 and 79 years. The consumption of a variety of fruits, non-starchy vegetables and unprocessed cereals in daily meals was low in this sample. Frequent consumption of fried foods; fast foods; sugary, carbonated beverages; processed, high-fat and high-sodium foods; and low fruit and non-starchy vegetable intake were evident. The findings are crucial to the development for culturally-specific nutrition education intervention programs for African Americans in the rural South targeted at the modification of not only diet, but food preparation methods to reduce cancer risk.

Living with oral cancer: epidemiology with particular reference to prevalence and life-style changes that influence survival

This review presents data on incidence, mortality, survival and trends on cancers of the lip, oral cavity and oropharynx using available recent data sources around the world. Oral and pharyngeal cancer, grouped together is the sixth most common cancer in the world. The review focuses primarily on prevalence of people still alive after an oral cancer diagnosis. In the world, there is close to a three quarter of a million people who previously had oral cancer and alive at 5years after diagnosis. The proportion alive at 5years is lower in less developed countries compared to earlier years. Within in Europe highest prevalence at 5years is seen in Western Europe. Our prevention strategies for this high risk group should include offering smoking cessation and other risk reduction measures. Smoking cessation in particular improves prognostic outcomes reducing the risk of secondary disease by approximately 2-3-fold.

Overview of cancer for the healthcare team: aetiopathogenesis and early diagnosis

Much cancer presents late, at a stage when not only is more radical treatment necessary, but the prognosis is also less favourable. This paper attempts to provide an overview of the aetiopathogenesis of cancer (carcinoma) for the healthcare team, a broad understanding of which is crucial for coping with issues related to prevention, diagnosis and management. Prevention of cancer involves lifestyle decisions which afford protection not only against cancers in many sites, but also against a wide range of other conditions, many of which are equally life-threatening. The paper also highlights areas of controversy in the early diagnosis of oral cancer. Earlier diagnosis is likely to be achieved reliably only with the introduction of molecular studies.

Betel-quid chewing with or without tobacco is a major risk factor for oral potentially malignant disorders in Sri Lanka: a case-control study

We investigated the prevalence of, and risk factors for, oral potentially malignant disorders (OPMDs) in rural Sri Lanka. A cross-sectional community-based study was conducted by interview and oral examination of 1029 subjects aged over 30 years. A community-based nested case-control study then took those with OPMDs as 'cases', "controls" being those with no oral abnormalities at time of initial screening. The prevalence of OPMD was 11.3% (95% CI: 9.4-13.2), after weighting for place of residence and gender. Risk factors were betel-quid (BQ) chewing daily [OR=10.6 (95% CI: 3.6-31.0)] and alcohol drinking daily or weekly [OR=3.55 (1.6-8.0)]. A significant dose-response relationship existed for BQ chewing. Smoking did not emerge when adjusted for covariates. A synergistic effect of chewing and alcohol consumption existed. The attributable risk (AR) of daily BQ chewing was 90.6%, the population AR 84%. This study demonstrates high prevalence of OPMD, betel-quid chewing with or without tobacco being the major risk factor.

Causes of oral cancer--an appraisal of controversies

Major risk factors for oral cancer are cigarette smoking and alcohol misuse. Among Asian populations, regular use of betel quid (with or without added tobacco) increases oral cancer risks. Dentists should be aware of some emerging risk factors for oral, and particularly oropharyngeal cancer such as the role of the human papillomavirus infection (HPV). Decreases in risk could be achieved by encouraging high fruit and vegetable consumption. Some controversies related to the aetiology of this disease also need clarification. The objective of this paper is to provide an opinion on these debated controversies.

[Squamous cell carcinoma and potentially malignant disorders of the oral mucosa]

Squamous cell carcinoma is the most frequent malignant tumor of the oral mucosa. Various endogenous and exogenous factors promote its development. Therapy and prognosis depend mainly on tumor stage. Early detection is therefore of utmost importance. In most cases cancer develops from "leukoplakia". Both homogeneous leukoplakias as well as "erythroleukoplakias" should be biopsied. The"brush-biopsy", imaging techniques, molecular biologic or DNA tests are not reliable enough at present, often technically demanding and not applicable in daily practice. In extensive lesions "field cancerization" has to be considered. Further important precursor lesions are proliferative verrucous leukoplakia and erosive lichen planus. The management of oral precancerous lesions should be individually tailored: Low-grade dysplasia can be observed. If indicated, patients at risk should be biopsied in intervals. High-grade dysplasia ("carcinoma in situ") should be surgically removed.