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Agarwal N, Shaikh MN, Banu A, Ahuja P. Repercussions of Smokeless Tobacco on Buccal Mucosa: A Community Based Observational Study at a Tertiary Care Centre in Western Rajasthan. Indian J Otolaryngol Head Neck Surg 2024; 76:1891-1897. [PMID: 38566678 PMCID: PMC10982187 DOI: 10.1007/s12070-023-04440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/07/2023] [Indexed: 04/04/2024] Open
Abstract
Background Tobacco is consumed mainly as smoking or smokeless tobacco [SLT]. "Smokeless tobacco" (SLT) term is used for the consumption of tobacco mixed with other constituents in form of chewing, spitting and dipping. Consumers of smokeless tobacco chew the products and spit out the juice that builds up in oral cavity which leads to various malignant and pre malignant lesions of oral cavity. Methods Descriptive observational study was conducted in the city of Jodhpur through department of ENT, Head & Neck Surgery, Dr. SN medical college, Jodhpur. Results Male to female ratio of smokeless tobacco usage was almost same. Increasing age was associated with occurrence of oral lesions and 43% patients developed oral lesions in the group > 64 yrs of age. Duration was another associating factor and 66% developed symptoms within < 10 years of usage. Oral submucous fibrosis is the most common lesion. Malignant lesions were seen in 0.3% cases. Around 78% cases developed dependency. Diabetic patients were seen more prone to development of oral lesions. Conclusions Development of lesions in the oral cavity by smokeless tobacco depends on various factors such as quantity of tobacco usage per day, place of putting tobacco and duration. Awareness regarding its fatal effects and timely diagnosis and management can save many lives.
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Affiliation(s)
- Navneet Agarwal
- Department of Otorhinolaryngology and Head and Neck Surgery, Dr. S.N. Medical College and M.D.M. Hospital, Jodhpur, Rajasthan 342003 India
| | - Mohammed Nadeem Shaikh
- Department of Otorhinolaryngology and Head and Neck Surgery, Dr. S.N. Medical College and M.D.M. Hospital, Jodhpur, Rajasthan 342003 India
| | - Anisha Banu
- Department of Anaesthesia, Dr. S.N. Medical College and M.D.M. Hospital, Jodhpur, Rajasthan 342003 India
| | - Paridhi Ahuja
- Department of Otorhinolaryngology and Head and Neck Surgery, Dr. S.N. Medical College and M.D.M. Hospital, Jodhpur, Rajasthan 342003 India
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Galib R, Ahmed A, Gupta N, Khan R, Sharma SC. A Comparative Study of the Treatment of Oral Premalignant Lesions with Surgical Excision and Medical Therapy. Indian J Otolaryngol Head Neck Surg 2024; 76:1965-1971. [PMID: 38566720 PMCID: PMC10982230 DOI: 10.1007/s12070-023-04467-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/21/2023] [Indexed: 04/04/2024] Open
Abstract
Introduction Potentially malignant oral epithelial lesions are a group of oral conditions with an altered morphological state of the normal mucosal lining and include different lesions such as leukoplakia, erythroplakia, submucosal fibrosis, and lichen planus. Aim To compare the outcome of premalignant oral lesions after medical therapy consisting of submucosal intralesional injection of triamcinolone with hyaluronidase and surgical excision. Materials and Methods This was a comparative prospective interventional study and the study was conducted among 50 patients presented to the Department of Otorhinolaryngology with premalignant oral lesions from the year 2020 to 2022. Patients were divided into two groups by random allocation, group A was treated with medical therapy, and Group B was treated with surgical excision and followed for a minimum of 6 months and the outcome has been categorized. Results All patients were divided into two groups-group A and group B, group A consisted of 22 (44%) patients who were given medical therapy, and group B consisted of 28 (56%) patients who underwent surgical excision. In group A, the clinical response was seen in 8 (36.36%) and in group B, the clinical response was seen in 18 (64.29%) patients. Conclusion Surgical excision was found to be better with more cases of clinical response (64.29%) when compared to medical treatment (36.36%) with a p value of 0.0497 which is significant whereas malignant transformation was almost equal in medical therapy and surgical treatment which was 13.64% and 14.28%, respectively.
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Affiliation(s)
- Rubina Galib
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - Aftab Ahmed
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - Nainsi Gupta
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - Roobina Khan
- Department of Pathology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - S. C. Sharma
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
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Wadde KR, Gajare PP, Sachdev SS, Singhavi HR. Prevalence and Malignant Transformation Rate of Oral Erythroplakia Worldwide - A Systematic Review. Ann Maxillofac Surg 2024; 14:76-80. [PMID: 39184413 PMCID: PMC11340826 DOI: 10.4103/ams.ams_181_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/18/2023] [Accepted: 01/24/2024] [Indexed: 08/27/2024] Open
Abstract
Background To determine the characteristics of oral erythroplakia (OE) on a global scale, it is important to analyse and evaluate findings from various studies conducted across multiple geographical locations. Objectives This review was conducted to determine the prevalence and malignant transformation rate (MTR) of OE. Data Sources A systematic search was performed to identify studies reporting the prevalence and MTR of OE across various databases - PubMed, Web of Science, Google Scholar, Elsevier and ScienceDirect without any restriction for the time of publication. Study Eligibility Criteria This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines, and the protocol was registered in the PROSPERO database (ID: CD42023395215). Results The prevalence rate of OE reported across the studies ranged from 0.04% to 1.14% with a mean of 0.25 + 0.002%. The MTRs reported across the studies included ranged from 2.6% to 65% with a mean of 30 ± 0.2%. Limitations and Conclusions Based on the findings from the present review, it can be concluded that while the range of MTRs of OE varies widely across different geographical locations, the average rate can be considered 30%. The review also identified a need for conducting more studies on the prevalence rates as well as longitudinal studies assessing the MTR across different regions.
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Affiliation(s)
- Kavita Ramesh Wadde
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Priyanka Prakash Gajare
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Sanpreet Singh Sachdev
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
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Shrestha G, Gautam DK, Siwakoti B, Pradhananga KK, Mulmi R. Community-based Screening of Oral Cancer in Selected Districts of Nepal: A Cross-Sectional Study. Asian Pac J Cancer Prev 2023; 24:4111-4115. [PMID: 38156845 PMCID: PMC10909109 DOI: 10.31557/apjcp.2023.24.12.4111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE Oral cancer screening plays a vital role in the prevention and control of oral cancer. This study aimed to determine the prevalence of oral potentially malignant disorders (OPMDs) in the Nepalese community. METHODS A cross-sectional study was conducted in six purposively selected districts in Nepal from May to December 2019. It utilized a camp-based approach, where a standardized questionnaire was administered through face-to-face interviews. Screening of oral cancer was performed by direct visualization and palpation. The study included adults aged 18 years and above, while those already diagnosed with oral cancer were excluded. Logistic regression was used to find out the association between OPMDs and the related variables. RESULTS A total of 1930 participants with a mean age of 44.3 years (SD=15.1) underwent oral cancer screening. Among them, 32% were current tobacco users, 2% were ex-users, and 11% were alcohol consumers. OPMDs, including suspected cancer, were identified in 139 (7.2%, 95% CI=6.1-8.4) participants. The most common lesion detected was leukoplakia (4.2%), followed by submucous fibrosis (1.5%), erythroplakia (0.9%), and palatal changes due to reverse smoking (0.1%). Additionally, 10 participants were suspected of having oral cancer. Older age group (AOR=7.00; 95% CI=2.76-17.77), male gender (AOR=2.52; 95% CI=1.58-4.02), tobacco chewers (AOR = 14.30; 95% CI=8.82-23.19), and smokers (AOR=4.67; 95% CI=2.88-7.57)) were identified as predictors of OPMDs. CONCLUSION This study revealed a high prevalence of OPMDs in Nepal, highlighting the need for oral cancer screening. The findings emphasize the importance of developing strategies to reduce tobacco use and implementing tobacco cessation intervention programs in Nepal to alleviate the burden of oral cancer.
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Affiliation(s)
- Gambhir Shrestha
- Department of Community Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
| | - Dej Kumar Gautam
- Department of Surgical Oncology, B.P. Koirala Memorial Cancer Hospital, Chitwan, Nepal.
| | - Bhola Siwakoti
- Department of Cancer Prevention, Control and Research, B.P. Koirala Memorial Cancer Hospital, Chitwan, Nepal.
| | | | - Rashmi Mulmi
- Department of Cancer Prevention, Control and Research, B.P. Koirala Memorial Cancer Hospital, Chitwan, Nepal.
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Gupta B, Gupta A, Singh N, Bhushan Singh R, Gupta V. Occurrence of Oral Premalignant Lesions Among Tobacco Users in a Tribal Population: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e47162. [PMID: 38022083 PMCID: PMC10652032 DOI: 10.7759/cureus.47162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
This review aimed to comprehensively assess the association between tobacco use and oral health outcomes, specifically the presence of premalignant lesions (PMLs), through a synthesis of multiple assessments conducted in diverse populations. A systematic search of relevant literature was performed, and studies meeting the inclusion criteria were selected using appropriate Medical Subject Headings (MeSH) words and Boolean operators. Data from these studies was pooled and analysed using Review Manager 5.4 (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen). The Newcastle-Ottawa scale was used to assess the methodological quality of the studies included. The pooled analysis of the five selected papers revealed a significant correlation between tobacco use and an increased prevalence of PMLs among tobacco users. Tobacco users had an odds ratio of 15.22 (95% CI: 10.01-23.15) as compared to non-user cohorts, significant at p 0.0001. This comprehensive synthesis of assessments underscores the detrimental impact of tobacco use on oral health, particularly in terms of potentially malignant lesions. The findings emphasise the urgency of targeted public health interventions to address tobacco consumption and promote oral health awareness, especially in populations with high tobacco consumption rates. Standardisation of methodologies and representation of diverse populations in future research would strengthen the evidence base and facilitate more effective strategies to improve oral health outcomes globally.
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Affiliation(s)
- Bhavana Gupta
- Department of Oral Pathology and Microbiology, Faculty of Dentistry, People's University, Bhopal, IND
| | - Anish Gupta
- Department of Oral Pathology and Microbiology, People's Dental Academy, People's University, Bhopal, IND
| | - Neha Singh
- Periodontology, Private Practitioner, Ranchi, IND
| | - Rajeev Bhushan Singh
- Department of Oral Pathology and Microbiology, Awadh Dental College and Hospital, Jamshedpur, IND
| | - Vivek Gupta
- Department of Periodontology and Oral Implantology, Dental Institute, Rajendra Institute of Medical Sciences (RIMS), Ranchi, IND
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Taruna T, Singh YP, Waghmare R, Sinha A, Priya L, Sharma V, Singh UB. Analyzing the Frequency of Premalignant Lesions and Oral Malignancy in Indian Subjects Attending Outpatient Department From the Low Socioeconomic Group. Cureus 2023; 15:e42035. [PMID: 37593263 PMCID: PMC10431911 DOI: 10.7759/cureus.42035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Oral cancer is a rapidly growing disease among Indian subjects mainly in the low socioeconomic group. Socially and economically marginalized subjects are at high risk for oral cancer because of smoke and smokeless tobacco consumption. AIM To evaluate the prevalence of precancerous lesions and oral cancer and evaluate tobacco as a causative factor in Indian subjects visiting the outpatient department of the institute. METHODS Around 658 subjects were analyzed for frequency of premalignant lesions and oral malignancy in Indian subjects from the low socioeconomic group. Patients visited for pain, burning, or ulceration in the oral cavity were clinically assessed for any tissue growths, leathery alterations, ulcerative changes, and white or red lesions in the oral cavity. Results: The overall prevalence of smokeless and smoking tobacco was 78.8% (n=518) and 65.2% (n=429) respectively in the present study. Around 39.8% (n=262) of samples were stained positive for precancerous and cancerous lesions of the oral cavity. The highest number of positive samples were from buccal mucosa with 36.2% (n=238) subjects and 6.1% (n=40) for labial mucosa. CONCLUSIONS Oral cancer is highly prevalent in Indian subjects owing to high tobacco consumption rates and habits warranting the cessation center a priority. Also, early detection and screening are vital to attaining better outcomes. More tobacco cessation centers are needed to stop the habit and early diagnosis will prevent dysplastic changes.
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Affiliation(s)
- Taruna Taruna
- Public Health Dentistry, Patna Medical College and Hospital, Patna, IND
| | - Yatendra P Singh
- Otorhinolaryngology, Saraswati Medical College and Hospital, Unnao, IND
| | - Renu Waghmare
- Preventive Social Medicine, Nandkumar Singh Chouhan Government Medical College, Khandwa, IND
| | - Abhishek Sinha
- Dentistry, Patna Medical College and Hospital, Patna, IND
| | - Leena Priya
- Oral Medicine and Radiology, Patna Medical College and Hospital, Patna, IND
| | - Varsha Sharma
- Periodontology, Bhabha College of Dental Sciences, Bhopal, IND
| | - Uday B Singh
- Oral and Maxillofacial Surgery, Recarve Maxillofacial Centre and Dental Studio, Delhi, IND
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Muthanandam S, Babu BV, Muthu J, Rajaram S, Sundharam BS, Kishore M. Burden of oral precancer and cancer among an indigenous tribal population of South India - An evaluative study. Indian J Dent Res 2022; 33:253-257. [PMID: 36656183 DOI: 10.4103/ijdr.ijdr_552_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Context Oral cancer is of major concern in the Indian subcontinent and is found to be high among low socioeconomic groups. One such high-risk group is considered to be the tribal people, who are economically and socially marginalised. Aims The aim of the present study is to assess the prevalence of oral cancer and precancer lesions among the Narikurava population in Puducherry state, India. Methods and Material A total of 329 Narikurava tribal people were included in this study. Data was collected by clinical examination of the oral cavity by door-to-door screening. The oral cavity was examined for white/red lesions, ulcerative changes, leathery changes and tissue growths. Statistical Analysis Used Prevalence was calculated in terms of percentages. Descriptive statistics included the calculation of percentages, mean, and standard deviation. Results The prevalence of precancer in the population is 48.3%. The majority of the lesions were observed in the buccal mucosa: 41.6% had white lesions, 9.1% had red lesions, 0.3% had ulcerations or growth, and 28.3% had leathery changes followed by the labial mucosa: 0.6% had white lesions, 0.6% had red lesions, 0.3% had ulcerations or growth and 16.4% had leathery changes. Conclusions The present study observed a high prevalence of precancerous lesions among the Narikurava tribe. The main reason for the high prevalence is attributed to tobacco and tobacco-related habits. Hence, cancer control activities should be prioritised. Designing a model to detect precancer and cancer early and to constantly monitor the detected cases in such populations is of utmost importance.
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Affiliation(s)
- Sivaramakrishnan Muthanandam
- Department of Oral & Maxillofacial Pathology & Oral Microbiology, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth (Deemed to be) University, Pondicherry, India
| | - Bontha V Babu
- Socio-Behavioural and Health Systems Research (SB and HSR), Division, Indian Council of Medical Research, New Delhi, India
| | - Jananni Muthu
- Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth (Deemed to be) University, Pondicherry, India
| | - Suganya Rajaram
- Department of Oral & Maxillofacial Pathology & Oral Microbiology, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth (Deemed to be) University, Pondicherry, India
| | - B Sivapatha Sundharam
- Principal, Department of Oral Pathology, Priyadarshini Dental College, Chennai, Tamil Nadu, India
| | - M Kishore
- Research Assistant, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth (Deemed to be) University, Pondicherry, India
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Muthu J, Muthanandam S. Exploring the reasons behind delayed presentation of oral cancers: Preliminary means to increase the chances of survival. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_148_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Acharya S, Singh S, Bhatia SK. Association between Smokeless Tobacco and risk of malignant and premalignant conditions of oral cavity: A systematic review of Indian literature. J Oral Maxillofac Pathol 2021; 25:371. [PMID: 34703140 PMCID: PMC8491328 DOI: 10.4103/0973-029x.325258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 05/18/2021] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
Abstract
Causative linkages of tobacco use with oral potentially malignant disorders and cancers of oral cavity have been studied. Oral squamous cell carcinoma is one of the most common cancers in India. The International Agency for Research on Cancer (IARC) monograph found a significant association between smokeless tobacco (SLT) use and oral cancer. However, only a few limited studies have been represented on the IARC monograph. Published meta-analyses have provided pooled risk estimates for oral cancers caused by tobacco, both on global and regional levels. This systematic review was aimed at summarizing all the available studies exclusively in India by collecting data from PubMed and Medline. Emphasis was laid on cohort and case–control studies, and a few cross-sectional studies for premalignant lesions were also discussed. A significant association was noticed on SLT and premalignant and malignant oral cavity lesions.
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Affiliation(s)
- Shivesh Acharya
- Department of Dentistry, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
| | - Shruti Singh
- Department of Dentistry, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
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Patel JR, Rupani MP. Costs incurred by patients with oral potentially malignant disorders: is there a public health need for financial protection in India? BMC Res Notes 2021; 14:396. [PMID: 34689827 PMCID: PMC8543918 DOI: 10.1186/s13104-021-05814-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/15/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives Financial protection mechanisms are in place to overcome the costs of a few diseases in India. Our objective was to estimate the costs incurred due to Oral Potentially Malignant Disorders (OPMD) and to determine predictors of such costs. Results We found that the median (Interquartile range IQR) total costs of OPMD was Indian Rupees (INR) 500 (350–750), direct medical costs was INR 0 (0–50), direct non-medical costs was INR 150 (40–200) and indirect costs was INR 350 (250–500). The travel cost to attend the health facilities [INR 100 (40–150)] and the patient’s loss of wages [INR 200 (150–400)] mainly accounted for the direct non-medical and indirect costs respectively. The median expenditure on smokeless and smoking forms of tobacco was INR 6000 (5400–7200) and INR 2400 (1800–3600) respectively. On multiple linear regression analysis, rural residence, belonging to below poverty line family, being a sole earner in the family, number of months since diagnosis and first visit at a private provider were found to be the significant predictors of total costs of OPMD. Financial protection mechanisms are needed for covering the direct non-medical and indirect costs. Early management of OPMD might mitigate the costs of OPMD. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05814-2.
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Affiliation(s)
- Jay R Patel
- Department of Community Medicine, Government Medical College Bhavnagar (Maharaja Krishnakumarsinhji Bhavnagar University), Near ST bus stand, Jail Road, Bhavnagar, Gujarat, 364001, India
| | - Mihir P Rupani
- Division of Clinical Epidemiology, ICMR-National Institute of Occupational Health (NIOH), Meghani Nagar, Ahmedabad, Gujarat, 380016, India.
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