Multi‐ethnic variations in the practice of oral cancer risk habits in a developing country

Abstract

Objective To elucidate ethnic variations in the practice of oral cancer risk habits in a selected Malaysian population. Methods This retrospective case–control study involves 790 cases of cancers of the oral cavity and 450 controls presenting with non‐malignant oral diseases, recruited from seven hospital‐based centres nationwide. Data on risk habits (smoking, drinking, chewing) were obtained using a structured questionnaire via face‐to‐face interviews. Multiple logistic regression was used to determine association between risk habits and oral cancer risk; chi‐square test was used to assess association between risk habits and ethnicity. Population attributable risks were calculated for all habits. Results Except for alcohol consumption, increased risk was observed for all habits; the highest risk was for smoking + chewing + drinking (aOR 22.37 95% CI 5.06, 98.95). Significant ethnic differences were observed in the practice of habits. The most common habit among Malays was smoking (24.2%); smoking + drinking were most common among Chinese (16.8%), whereas chewing was the most prevalent among Indians (45.2%) and Indigenous people (24.8%). Cessation of chewing, smoking and drinking is estimated to reduce cancer incidence by 22.6%, 8.5% and 6.9%, respectively. Conclusion Ethnic variations in the practice of oral cancer risk habits are evident. Betel quid chewing is the biggest attributable factor for this population.

Can post-treatment oral cancer patients’ concerns reflect their cancer characteristics, HRQoL, psychological distress level and satisfaction with consultation?

“…This study was conducted at multiple study sites to represent patients' variation in terms of ethnicity and practices in Malaysia [45,46]. Thus, the outcomes interpreted in this study are deemed to reflect the post-treatment oral cancer population throughout the country.…”

Mouth self‐examination as a screening tool for oral potentially malignant disorders among a high‐risk Indigenous population

“…Due to the remote areas of their residence as well as their low SES status, dental services utilization among this particular ethnic group, which is mainly provided by the Malaysian government at a very minimal cost, is low, thus adding to their increased risk. In addition, this ethnic group was also observed to indulge in oral cancer risky habits . For the reasons as stated above, this ethnic group has been chosen as the sample for this study.…”

Oral Cancer Awareness and Knowledge among Marginalised Group in Sungai Petani, Kedah, Malaysia

“…The population of Paya Nahu comprised of low socio-economic status (SES) as majority of them earned less than RM1,000 and none of them earned more than RM3,000. Based on Malaysia's per capita income, low SES is defined as earning less than RM3,000 (≈ USD740)/month (Ghani et al, 2019).…”

“…This fact is attributed by the lack of awareness and knowledge especially the sign and symptoms of oral cancer (Ghani et al, 2013). Being multi-racial in Malaysia, oral cancer incidence varies by ethnic group whereby half of the oral cancer cases in Malaysia were among the Indian population (Ghani et al, 2019). This could be due to the prevalent betel quid chewing habit among the Indians which also suggests that the occurrence of oral cancer is predisposed by lifestyle and cultural practices (Ghani et al, 2019).…”

“…The Paya Nahu community in Sungai Petani, Kedah was appropriate population for this study as it matches the definition of low socioeconomic status based on Malaysia's per capita income whereby their income were less than RM3,000 (Ghani et al, 2019) and additionally because of their unconducive living environment and low education level. The outcome of this study could be highlighted to the authorities in improving the livelihood level of the community.…”