Smokeless Tobacco and Oral Potentially Malignant Disorders in South Asia: A Systematic Review and Meta-analysis

Khan, Zohaib; Khan, Sheraz Ahmad; Christianson, Lara; Rehman, Sara; Ekwunife, Obinna Ikechukwu; Samkange‐Zeeb, Florence

doi:10.1093/ntr/ntw310

Cited by 28 publications

(34 citation statements)

References 61 publications

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“…OL and OE are associated with smoking and alcohol consumption; furthermore, these are the conditions that are most commonly reported in western countries . OSMF is commonly reported in areca nut users; therefore, its prevalence is higher in the Asian populations . OLP is a recurrent inflammatory disorder of the skin and mucous membranes, and there is limited evidence with regard to its risk of malignant transformation .…”

Section: Introductionmentioning

confidence: 99%

“…5 OSMF is commonly reported in areca nut users; therefore, its prevalence is higher in the Asian populations. 6 OLP is a recurrent inflammatory disorder of the skin and mucous membranes, and there is limited evidence with regard to its risk of malignant transformation. 7 AC is associated with solar radiation; therefore, it is more frequently reported in tropical countries, and it affects mainly white males and outdoor workers.…”

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confidence: 99%

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Prevalence of oral potentially malignant disorders: A systematic review and meta‐analysis

Mello

Miguel

Dutra

et al. 2018

J Oral Pathology Medicine

276

190

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Oral potentially malignant disorders (OPMD) are chronic conditions, which have a higher risk of transformation to oral squamous cell carcinoma. The aim of this systematic review and meta-analysis was to answer the question: "What is the prevalence of oral potentially malignant disorders among adults?" Studies reporting the prevalence of these conditions (leukoplakia, erythroplakia, oral submucous fibrosis [OSMF], and actinic cheilitis) were selected, only studies in which a clinical assessment and histopathological confirmation were performed were included. Of the 5513 studies, 22 met the inclusion criteria for qualitative and quantitative analyses. The risk of bias (RoB) of the selected studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Seven studies were classified as high risk, 12 as moderate risk, and 3 as low RoB. The meta-analysis showed that the prevalence of OPMD was 4.47% (95% CI = 2.43-7.08). The most prevalent OPMDs were OSMF (4.96%; 95% CI = 2.28-8.62) and leukoplakia (4.11%; 95% CI = 1.98-6.97). OPMDs were identified more commonly in males (59.99%; 95% CI = 41.27-77.30). Asian and South American/Caribbean populations had the highest prevalence rates of 10.54% (95% CI = 4.60-18.55) and 3.93% (95% CI = 2.43-5.77), respectively. The overall prevalence of OPMD worldwide was 4.47%, and males were more frequently affected by these disorders. The prevalence of OPMD differs between populations; therefore, further population-based studies may contribute to the better understanding of these differences.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Prevalence of oral potentially malignant disorders: A systematic review and meta‐analysis

Mello

Miguel

Dutra

et al. 2018

J Oral Pathology Medicine

276

190

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“…7 The prevalence of OPMDs worldwide ranges from 1 to 5%; 8 and their potential for them to undergo malignant transformation ranges from 1 to 36%, depending on the subtype of OPMD. 9 This study seeks to quantify the risk associated with SLT use and the development of OPMDs in South Asia.…”

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confidence: 99%

“…9 This study seeks to quantify the risk associated with SLT use and the development of OPMDs in South Asia. 7 Fifteen articles corresponding to eighteen studies, pertaining to three of the seven countries in South Asia, were included in the meta-analysis. A substantial risk association between SLT use and OPMDs was estimated from the pooled data (meta odds ratio, mOR = 15.5; 95% CI, 9.9-24.2).…”

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confidence: 99%

“…Moreover, the quantification of SLT exposure in these studies was also identified by the authors as a problem and limitation -particularly the lack of a clear definition for "ever" exposure may cause over estimation of the true risk as an individual who has used SLT once was categorised in the same group as someone who used SLT for 20 years. 7 This review is a good baseline description of the extent of epidemiological research into SLT and OPMD risk in South Asia. It points to the need for further research into this risk association, and indeed for the risk associations between SLT, OPMD and oral cancer.…”

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Smokeless tobacco – a substantial risk for oral potentially malignant disorders in South Asia

Seenan

Conway

2017

Evid Based Dent

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Tobacco Use and Incidence of Adverse Oral Health Outcomes Among US Adults in the Population Assessment of Tobacco and Health Study

et al. 2022

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ImportanceEvolving tobacco use patterns, including increasing electronic nicotine delivery systems (ENDS) use, warrant re-examination of the associations between tobacco use and oral health.ObjectiveTo examine associations between tobacco product use and incidence of adverse oral health outcomes.Design, Setting, and ParticipantsThis cohort study used nationally representative data from wave (W) 1 to W5 (2013-2019) of the Population Assessment of Tobacco and Health Study. Recruitment used a stratified address-based, area-probability household sample of the noninstitutionalized US civilian population. The W1 cohort included respondents aged 18 years and older without lifetime history of oral health outcomes at W1 or W3, depending on when the outcome was first assessed. Data analysis was performed from October 2021 to September 2022.ExposuresCurrent (every day or someday use) established (lifetime use of at least 100 cigarettes or “fairly regular” use of other products) use of cigarettes, ENDS, cigars, pipes, hookah, snus, and smokeless tobacco, excluding snus at W1 to W4.Main Outcomes and MeasuresThe primary outcomes were past 12-month self-reported diagnosis of gum disease and precancerous oral lesions (W2-W5) and bone loss around teeth, bleeding after brushing or flossing, loose teeth, and 1 or more teeth removed (W4-W5).ResultsSample sizes varied across the 6 oral health outcomes (13 149 respondents for the gum disease sample, 14 993 respondents for the precancerous oral lesions sample, 16 312 respondents for the bone loss around teeth sample, 10 286 respondents for the bleeding after brushing or flossing sample, 15 686 respondents for the loose teeth sample, and 12 061 respondents for the 1 or more teeth removed sample). Slightly more than half of adults (52%-54% across the 6 samples) were women, and the majority were of non-Hispanic White race and ethnicity. Cox proportional hazards models were developed with covariates that included time-dependent tobacco use variables mutually adjusted for each other. Cigarette smoking was positively associated with incidence of gum disease diagnosis (adjusted hazard ratio [AHR], 1.33; 95% CI, 1.11-1.60), loose teeth (AHR, 1.35; 95% CI, 1.05-1.75), and 1 or more teeth removed (AHR, 1.43; 95% CI, 1.18-1.74). Cigar smoking was positively associated with incidence of precancerous oral lesions (AHR, 2.18; 95% CI, 1.38-3.43). In addition, hookah smoking was positively associated with incidence of gum disease diagnosis (AHR, 1.78; 95% CI, 1.20-2.63), and ENDS use was positively associated with incidence of bleeding after brushing or flossing (AHR, 1.27; 95% CI, 1.04-1.54). No associations were observed between snus and smokeless tobacco excluding snus and incidence of oral health outcomes.Conclusions and RelevanceThe observed associations of combustible tobacco use with incidence of several adverse oral health outcomes and ENDS use with incidence of bleeding after brushing or flossing highlight the importance of longitudinal studies and emphasize the continued importance of tobacco cessation counseling and resources in clinical practice.

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Smokeless Tobacco and Oral Potentially Malignant Disorders in South Asia: A Systematic Review and Meta-analysis

Cited by 28 publications

References 61 publications

Prevalence of oral potentially malignant disorders: A systematic review and meta‐analysis

Prevalence of oral potentially malignant disorders: A systematic review and meta‐analysis

Smokeless tobacco – a substantial risk for oral potentially malignant disorders in South Asia

Tobacco Use and Incidence of Adverse Oral Health Outcomes Among US Adults in the Population Assessment of Tobacco and Health Study

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