Risk factors for multiple oral premalignant lesions

Abstract

Oral leukoplakia, oral submucous fibrosis and erythroplakia are 3 major types of oral premalignant lesions. Multiple oral premalignant lesions may possibly develop due to field cancerization, where carcinogenic exposures can cause simultaneous genetic defects to the upper aerodigestive tract epithelium, putting the epithelium at high risk for development of premalignant lesions at different stages of carcinogenesis. There have been no epidemiological studies on risk or protective factors of the disease. A case-control study was conducted with data from the baseline screening of a randomized oral cancer screening trial in Kerala, India. A total of 115 subjects with multiple oral premalignant lesions (8 -10% of oral premalignant lesions in our case series) were included: 64 subjects with oral leukoplakia and oral submucous fibrosis, 19 subjects with oral leukoplakia and erythroplakia, 22 subjects with oral submucous fibrosis and erythroplakia and 10 subjects with all 3 lesions. Individuals without oral lesions were considered controls (n‫.)377,74؍‬ The odds ratio (OR) for ever tobacco chewers was 37.8 (95% confidence interval (CI)‫-2.61؍‬ 88.1) when adjusted for age, sex, education, BMI, smoking, drinking and fruit/vegetable intake. Dose-response relationships were seen for the frequency (p<0.0001) and duration of tobacco chewing (p<0.0001) with the risk of multiple oral premalignant lesions. Whereas alcohol drinking may possibly be a risk factor for multiple oral premalignant lesions, smoking was not associated with the risk of multiple oral premalignant lesions (OR‫,9.0؍‬ 95%CI‫.)7.1-5.0؍‬ The results suggest that tobacco chewing was the most important risk factor for multiple oral premalignant lesions and may be a major source of field cancerization on the oral epithelium in the Indian population.

An integrated Approach to Worksite Tobacco Use Prevention and Oral Cancer Screening Among Factory Workers in Mumbai, india

“…In an oral cancer screening study in India, tobacco chewing was the most important risk factor for multiple oral premalignant lesions but smoking was not associated with the risk of multiple oral premalignant lesions (Thomas et al, 2003). Considering the fact that the present study showed significantly more oral pre cancer lesion among individuals with other medical ailments, amply demonstrates that tobacco and alcohol users in general are at greater risk for many major chronic diseases.…”

Trends in frequency and prevalence of oral cancer and oral squamous cell carcinoma in mexicans. A 20 years retrospective study

“…The most important risk factors for develops OSCC are smoking and chronic alcoholism (9 -11). 75% of all OSCC are related to one or both carcinogenic factors (12,13). An increase in the consumption of tobacco and alcohol in young Mexicans has been reported (11, 14 -16).…”

Role of curcumin in management of potentially malignant disorders: A review of literature

“…Studies show that human papillomavirus (HPV)-16 and HPV-18 are also considered to be the viral etiopathology of oral PMD. [14][15][16] Since oral PMD have a high tendency to transform into malignancy, there is a need to identify these disorders early and prevent their transformation to malignancy by various means.…”