There is uncertainty and limited recognition of the relationship between socioeconomic inequalities and oral cancer. We aimed to quantitatively assess the association between socioeconomic status (SES) and oral cancer incidence risk. A systematic review of casecontrol studies obtained published and unpublished estimates of the SES risk related to oral cancer. Studies were included which reported odds ratios (ORs) and corresponding 95% CIs of oral cancer with respect to SES, or if the estimates could be calculated or obtained. Meta-analyses were performed on subgroups: SES measure, age, sex, global region, development level, time-period and lifestyle factor adjustments; while sensitivity analyses were conducted based on study methodological issues. Forty-one studies provided 15,344 cases and 33,852 controls which met our inclusion criteria. Compared with individuals who were in high SES strata, the pooled ORs for the risk of developing oral cancer were 1.85 (95%CI 1.60, 2.15; n 5 37 studies) for those with low educational attainment; 1.84 (1.47, 2.31; n 5 14) for those with low occupational social class; and 2.41 (1.59, 3.65; n 5 5) for those with low income. Subgroup analyses showed that low SES was significantly associated with increased oral cancer risk in high and lower income-countries, across the world, and remained when adjusting for potential behavioural confounders. Inequalities persist but are perhaps reducing over recent decades. Oral cancer risk associated with low SES is significant and comparable to lifestyle risk factors. Our results provide evidence to steer health policy which focus on lifestyles factors toward an integrated approach incorporating measures designed to tackle the root causes of disadvantage. ' 2008 Wiley-Liss, Inc.Key words: meta-analysis; oral cancer; SES; socioeconomic status; systematic review In 2000, oral cancer (ICD-10 C00-06) was estimated to be the 8th most common cancer worldwide-with an estimated 267,000 new cases and 128,000 deaths, and with the greatest burden in developing countries. 1 Despite a wealth of literature on the effects of poverty and inequality on health, 2 the effect of socioeconomic circumstances on oral cancer is given little recognition in a predominant medical model approach to research and prevention on the risks of the disease. 3 Recent published work on the relationship between socioeconomic status (SES) and oral cancer has mainly been in the form of descriptive epidemiology studies linking routine registry data to census data. From such studies, increased risk of oral cancer appears associated with high levels of area-based socioeconomic deprivation, 4,5 although this was not reflected in a review of incidence studies from across the world which utilised mainly individual measures of SES. 6 Area-based measures are liable to the 'ecological fallacyÕ whereby individuals are allocated SES based on their area of residence. The few analytical studies to focus on SES have also been equivocal, and socioeconomic correlates have recently been found to be c...

No abstract

Low socioeconomic status has been reported to be associated with head and neck cancer risk. However, previous studies have been too small to examine the associations by cancer subsite, age, sex, global region and calendar time and to explain the association in terms of behavioral risk factors. Individual participant data of 23,964 cases with head and neck cancer and 31,954 controls from 31 studies in 27 countries pooled with random effects models. Overall, low education was associated with an increased risk of head and neck cancer (OR = 2.50; 95% CI = 2.02 – 3.09). Overall one-third of the increased risk was not explained by differences in the distribution of cigarette smoking and alcohol behaviors; and it remained elevated among never users of tobacco and nondrinkers (OR = 1.61; 95% CI = 1.13 – 2.31). More of the estimated education effect was not explained by cigarette smoking and alcohol behaviors: in women than in men, in older than younger groups, in the oropharynx than in other sites, in South/Central America than in Europe/North America and was strongest in countries with greater income inequality. Similar findings were observed for the estimated effect of low versus high household income. The lowest levels of income and educational attainment were associated with more than 2-fold increased risk of head and neck cancer, which is not entirely explained by differences in the distributions of behavioral risk factors for these cancers and which varies across cancer sites, sexes, countries and country income inequality levels.

Bone loss in smoker-related periodontitis patients may be partially explained by suppression of OPG production.

Cotinine, whatever the collection method and analysed by EIA kits, shows good differentiation between smokers and non-smokers. Salivary samples have the advantage of being non-invasive, although collection methodology is important, as cotinine levels may vary.