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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 2  |  Issue : 1  |  Page : 4-6

The Prevalence of Oral Cancer in Patients Consuming Tobacco Products: A Dental OPD Based Retrospective Study at IGIMS, Patna, Bihar


1 Associate Professor Dept. of Dentistry, Govt. Dental College, Chennai, India
2 MDs, Dept. of Conservative Dentistry (P.G. Student), Govt. Dental College, Chennai, India
3 Professor Dept. of RCC, PMCH, Patna, Bihar, India
4 Professor Dept. of Dentistry, PMCH, Patna, Bihar, India
5 Assistant Professor Dept. of community Medicine, PMCH, Patna, Bihar, India
6 MD, Assistant Professor, Department of Physiology, PMCH, Patna, Bihar, India

Date of Web Publication12-Feb-2016

Correspondence Address:
Sanjay Kumar
Associate Professor, Dept. of Dentistry, IGIMS, Patna-14, Bihar
India
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Source of Support: None, Conflict of Interest: None


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  Abstract 


Introduction: Oral cancer is the one of the most prevalent disease in Bihar. The main reason of oral cancer is the use of tobacco and tobacco related products. Seventy-five percent of all head and neck cancers begin in the oral cavity. According to the National cancer institute’s surveillance, epidemiology, and ends results (SEER) program, 30 percent of oral cancers originate in the tongue, 17 percent in the lip, and 14 percent in the floor of the mouth. Aim and Objective: The study was conducted for screening of oral cancer among tobacco consuming patients reported to dental OPD at IGIMS, Patna in male and female groups. Materials and Method: Retrospective study was conducted to access the prevalence of oral cancer among 4200 outpatients who reported to dental OPD at IGIMS, Patna from October 2011 to December 2014. The clinical diagnosis of oral cancer was made after intra-oral examination of patients showing characteristic features of oral cancer. The patients were grouped under male and female categories. According to[2],[12],[13] American oral cancer society following physical criteria is included for oral cancer detection. 1) Most common symptom is sore mouth with easy bleeding and ulcer doesn’t heal. 2. Most common sign of oral cancer is pain that doesn’t go away. 3. Lump or thickening in the cheek and lymph node enlargement, their consistency of lymph node are hard and painless. 4. Red or white patches on gingiva, tongue, floor of the mouth etc 5. Sore throat or feeling of something caught in the throat. 6. Difficulty in swallowing, eating, drinking water etc 7. Unexplained loss of teeth. 8. Numbness in the part of oral cavity. Results: The total numbers of oral cancer patients screened were 120. The prevalence of oral cancer in this study was 120 (2.86%). Majority of subjects were male, 85 out of 120 (70.8 %) in comparison to females, 35 out of 120 (29.16%). Conclusion: The findings of the study clearly indicate that prevalence of oral cancer and use of smokeless tobacco has direct relationship in causation of oral cancer. The male are consuming more tobacco products than female so, occurrences of oral cancer are more in male.

Keywords: Prevalence, oral cancer, smokeless tobacco


How to cite this article:
Kumar S, Biswas KP, Singh RK, Sharma A K, Kumar D, Kumar S, Rani V. The Prevalence of Oral Cancer in Patients Consuming Tobacco Products: A Dental OPD Based Retrospective Study at IGIMS, Patna, Bihar. J Indira Gandhi Inst Med Sci 2016;2:4-6

How to cite this URL:
Kumar S, Biswas KP, Singh RK, Sharma A K, Kumar D, Kumar S, Rani V. The Prevalence of Oral Cancer in Patients Consuming Tobacco Products: A Dental OPD Based Retrospective Study at IGIMS, Patna, Bihar. J Indira Gandhi Inst Med Sci [serial online] 2016 [cited 2022 Oct 2];2:4-6. Available from: http://www.jigims.co.in/text.asp?2016/2/1/4/303371




  Introduction: Top


[1],[2]Seventy-five percent of all head and neck cancers begin in the oral cavity. According to the National cancer institute’s surveillance, epidemiology, and ends results (SEER) program, 30 percent of oral cancers originate in the tongue, 17 percent in the lip, and 14 percent in the floor of the mouth. New data related to the HPV16 virus may indicate that these trends are changing with the posterior mouth including the tonsils, tonsillar pillar and crypt, the base of the tongue, and the oropharynx increasing rapidly in incidence rates. Tobacco is one of the most preventable causes of oral cancer. Although there is evidence that smoking (cigarette, cigar and pipe) is associated with oral cancer, the smokeless tobacco (often called chewing tobacco or spit tobacco) seems to be strongly associated with oral cancer[1]. In India, tobacco is one of the most important public health issues and used in various forms. In addition to smoking, tobacco consumption without smoke, in different forms, is common among both men and women[3]. The most common form of tobacco use in India are traditional forms like betel leaf (paan), a mixture of betel core leaf with areca nut; combinations of ingredients are altered according to individual preferences, chewing tobacco flakes with or without lime, tobacco tooth powder (Khaini, a black powder obtained by mincing tobacco, which is kept in gingival contact in vestibular area). The use of flavored tobacco is increasing among all age group people irrespective of men or women.[4] Tobacco chewing and smoking has been identified as the major risk factors for oral cavity pre-cancer and cancer in India. Polycyclic aromatic hydrocarbons, aldehydes, aromatic amines, nitrosamines, etc., are proved to be cancer promoting components present in tobacco. But chewing of tobacco combined with betel quid raises the amount of carcinogenic nitrosamines and reactive oxygen species in the mouth[5]. In India, tobacco consumption is responsible for half of all the cancers in men and a quarter of all cancers in women. India holds highest rates of oral cancer in the world, specifically due to high prevalence of tobacco chewing. Various forms of tobacco chewing include pan (a mixture of spices chewed with or without tobacco), pan-masala or gutkha (a chewable tobacco containing areca nut), and khaini (a powdered tobacco rubbed on the gums as toothpaste).[6],[8],[11]


  Materials and Method Top


A retrospective study was conducted in Dental outpatient department at IGIMS, Patna. The total numbers of patients screened were 4200 during October 2011 to December 2014 for oral cancer. The subjects with systemic diseases and any other malignancy apart from oral cancer were excluded from the study. The clinical diagnosis of oral cancer was made when subject showed specific characteristics features of oral cancer.[2],[11],[12],[13] According to American oral cancer society following physical criteria are included for oral cancer detection. 1. Most common symptom is sore mouth with easy bleeding and the ulcer doesn’t heal. 2. Most common sign of oral cancer is pain that doesn't go away. 3. Lump or thickening in the cheek and the lymph node enlargement The lymph nodes are hard in consistency and painless. 4. Red or white patches on gingiva, tongue, floor of the mouth etc 5. Sore throat or feeling of something caught in the throat. 6. Difficulty in swallowing, eating, drinking water etc 7. Unexplained loss of teeth. 8. Numbness in the part of oral cavity. Armamentariums used were sterile mouth mirror, explorer, tweezers, kidney tray, disposable surgical latex gloves, disposable mouth mask.
Table 1: Distribution of oral cancer

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Table 2: Distribution of oral cancer in tobacco chewers

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  Discussion Top


In this study we observed that out of 4200 subjects, 120 (2.86%) subjects recorded with oral cancer. Result also shows that out of 120 patients diagnosed with oral cancer 85 (70.83 %) subjects were men in comparison to women 35 (29.16%). In gutkha chewers (group-A): were 315 in number, out of which 36 were screened for oral cancer. (group-B): shows maximum number of oral cancer (49) out of 267 patients having tobacco habits, and the last group-C: subjects with mixed habits (510 people) out of which 35 patients screened for oral cancer. The above data clearly indicates that tobacco chewers (group-B) patients showed higher predilection for oral cancer due high carcinogenicity of tobacco products than (group -A and group -C) groups of patients. In India where chewing and smoking tobacco is practiced, there is an alarming incidence of oral cancer and these cases account for approximately 50% of all cancer cases (Schulz et al., 2009)[7],[11] The group-A and group -C patients shows more trends towards occurrence of oral submucous fibrosis than oral cancer. One third of the global burden of oral cancer is predominantly attributed to high prevalence of tobacco consumption within India. 9 The carcinogenicity of tobacco has been established from evidence presented in many standard studies. The carcinogenic nature of betel quid is based mostly on epidemiologic observations made in India, where betel quid nearly always includes tobacco, a known cause of oral cancer in its own right.[10] An association between tobacco-free betel quid chewing and oral cancer has never been observed, either because none of the usual betel quid ingredients contain carcinogens or because the sample size of betel quid chewers who did not drink or smoke was not sufficiently large to unravel the association.[11] It is interesting to note that of the smokeless tobacco and their products like khaini consumers shows high risk for oral cancer than pan-masala chewers and those who consume both. So betel quid and panmasala without tobacco products and arecanuts verses containing the tobacco and arecanuts in betel quid and panmasala study is required to reveal the association. The role of HPV virus in oral cancer is also a matter of research.[14]


  Conclusion Top


The findings of the study clearly indicate that the patient with tobacco habits are more prone to oral cancer than patients with chewing panmasala, betel quid and having mixed habits. The male are more prone for oral cancer than female due to socio- culture habits of chewing tobacco products.



 
  References Top

1.
Haumschild, MS and Haumschild RJ, 2009. The importance of oral health in long-term care. J Am. Med. Dir. Assoc., 10:667-71. PMID: 19883892  Back to cited text no. 1
    
2.
Oral cancer screening protocol, www.oral cancer foundation org(Via internet ,2015)  Back to cited text no. 2
    
3.
Pednekar, M.S.J.R. Hebert and P.C. Gupta, 2009. Tobacco use, body mass and cancer mortality in Mumbai cohort study. Cancer epidemiol. 33:424-30. PMID: 19854693  Back to cited text no. 3
    
4.
Abdoul H M, Abdolreza S J, Madhurima D and Debanshu B, American Journal of pharmacology and toxicology 5(1): 9-13,2010 ISSN 1557-4962  Back to cited text no. 4
    
5.
Mousumi M, Nilabja S, Ranjan R P, and Bidyut R, Cancer epidemiol biomarkers prev 2005; 14(9). September 2005  Back to cited text no. 5
    
6.
M Rani, S Bonu, P Jha, S N Nguyen, Tobacco control 2003;12:e4(http://www.tobaccocontrol.com/cgi/content/full/12/4/e4)  Back to cited text no. 6
    
7.
Schulz M PA, Reichart CA. Ramseier and M.M. Bornstein, 2009. Smokeless tobacco: A new risk factor for oral health? A review. Schweiz monatsschrzahnmed, 119:1095-1109. PMID: 20020590  Back to cited text no. 7
    
8.
Shankar, A., A. Mcmunn, A. Steptoe, 2010. Health- related behaviors in older adults relationships with socioeconomic status. Am. J. Prev. Med., 38:39-46. PMID: 20117555  Back to cited text no. 8
    
9.
Bhavana G, Asian Pacific J Cancer Prev, 14 (5), 3323-3329  Back to cited text no. 9
    
10.
Ko YC, Huatig YL, Lee CH, Chen MJ, Litt LM, Tsai CC: Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan, J Oral pathol med 1995:24:450-3  Back to cited text no. 10
    
11.
Sanjay K, Krishna PB et al ,Role of panmasala and tobacco related products in oral submucous fibrosis: a dental opd based observational study at tertiary care center, IGIMS, Patna, Bihar, journal of Indira Gandhi institute of medical sciences, vol.01(02), 2015,10-12.  Back to cited text no. 11
    
12.
www.Cancer.org,state of oral cancer facts and criteria for oral cancer detection(Via internet, 2015)  Back to cited text no. 12
    
13.
www.NHS.UK, mouth oral cancer choices. (Via internet, 2015).  Back to cited text no. 13
    
14.
Noureen MC, Pankaj C, Role of human papilloma virus in the oral carcinogenesis: an Indian perspective, J cancer res ther. 2009, vol.5 (2)71-77.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2]



 

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Abstract
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