Risk factors for cancer of the buccal and labial mucosa in Kerala, southern India.

Abstract

Study objective-The aim was to investigate risk factors for cancer of the buccal and labial mucosa in Kerala, southern India.Design-The investigation was a casecontrol study.Setting-Regional Cancer Centre, Trivandrum, Kerala, and local teaching hospitals.Participants-Cases were all those registered with oral cancers at the Regional Cancer Centre during 1983 and 1984 (n = 414). Controls (n = 895) were selected from admissions to the cancer centre who were found to have non-malignant conditions, or from patients attending outpatients in teaching hospitals of Trivandrum medical college with nonmalignant conditions.Measurements and main results-The risk in males of the following habits was investigated: pan (betel)-tobacco chewing, bidi and cigarette smoking, drinking alcohol, and taking snuff. Only pan-tobacco chewing was investigated in females as very few indulged in other habits. Among males predisposing effects were found for pantobacco chewing (p < 0-001), bidi smoking (p < 0001), drinking alcohol (p < 0-001), and taking snuff (p < 0-01). As in males, pantobacco chewing also had a predisposing effect in females (p < 0-001). Duration of use was a better predictor of risk than either daily frequency of use or total lifetime exposure, both for pan-tobacco chewing (especially if the habit started before age 21 years) and bidi smoking. However, there were also very high risks associated with the current occasional use of both factors. Pan

Epidemiology of Upper Aerodigestive Cancers Among Armed Forces Personnel and Their Families

“…Beedi smokers were at a greater risk than cigarette smokers in this study. This is similar to the findings of Sankarnarayan et a1 who have reported greater risk for bidi smokers than cigarette smokers for cancer of the buccal and labial mucosa [14], esophagus [15], and lar› ynx [16]. Quid chewers were found to be at greater risk of upper aero digestive cancers than non chewers in this study.…”

“…Quid chewing has long been held responsible for the high incidence of upper aero digestive cancer in India. Simi› lar findings have been reported by Sankar› narayan et al [14] and Iayant et al [17]. Signifi› cant association between quid chewing and oral and pharyngeal cancer has also been reported by Shanta [10], and Jussawalla [18].…”

Cancer patterns in eastern India: The first report of the Kolkata cancer registry

“…Tobacco chewing and smoking have been identified as the major risk factors for these cancers in India. 15,[17][18][19] Cancers of the oral cavity occupy the second-highest position among males in Kolkata. The prevalent chewing habits involve use of betel quid (betel leaf with tobacco, areca nut, lime), gutkha (dried mixture of betel quid and tobacco sold in attractive pouches), mawa and zarda (flavoured tobacco) or khaini (crude form of dried ground tobacco with lime).…”

Socio-Demographic Factors Related to Oral Cancer

“…This ratio seems to be vary from one study to the other in India for example, Sankaranarayanan et al (1990) has reported almost the same ratio (2:1) and Mehrotra et al (2003) has shown higher ratio (3.27); while lower ratios have been reported by Chattopadhyay (1989) (1.76:1). It may be due to the more exposure to risk factors such as tobacco and alcohol by men compare to women.…”