Smoking and Chewing of Tobacco in Relation to Cancer of the Upper Alimentary Tract

Sanghvi, L. D.; Rao, Karishma; Khanolkar, V. R.

doi:10.1136/bmj.1.4922.1111

Cited by 109 publications

(32 citation statements)

References 11 publications

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“…The proportion of smokers was reportedly higher among the control subjects as compared to oral cancer casees in some of the previous studies from India (Sanghvi et al, 1955;Shanta & Krishnamoorthy, 1959;Shanta & Krishnamoorthy, 1963), although Jayant et al, (1977) reported a relative risk of 4.7 with smoking for oral cancer. Cigarette smoking, except for a possible effect of occasional use, has not been found to be an independent risk factor in this study.…”

Section: Combinedmentioning

confidence: 80%

mentioning

confidence: 99%

“…The epidemiology of gingival carcinoma has been studied previously as part of a case spectrum consisting of other intra oral and head and neck cancers (Sanghvi et al, 1955;Shanta & Krishnamoorthy, 1959, 1963Wahi et al, 1965;Jussawalla & Deshpande, 1971;Jayant et al, 1977: Notani, 1988 Pan chewing, pan-tobacco chewing, bidi smoking, cigarette smoking, alcohol and nasal snuff inhalation were the habits ascertained for the cases and controls. Pan chewing is defined as chewing of a quid containing fresh betel leaves (Piper betle), arecanut (Areca catechu) and aqueous lime (calcium hydroxide).…”

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confidence: 99%

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Tobacco chewing, alcohol and nasal snuff in cancer of the gingiva in Kerala, India

Sankaranarayanan

Duffy²,

Padmakumary³

et al. 1989

Br J Cancer

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Summary A case-control study of cancer of the gingiva was carried out in Kerala, Southern India, using 187 cases and 895 hospital-based controls. We investigated the effects on risk in males of pan (betel)-tobacco chewing, bidi and cigarette smoking, drinking alcohol and taking snuff. In females only pan-tobacco chewing was investigated as very few females indulged in the other habits. Among males, significant positive associations with risk were observed for pan-tobacco chewing (P<0.001), bidi smoking (P<0.001), alcohol drinking (P<0.001) and snuff use (P<0.05). In females, pan-tobacco chewing had a similar predisposing effect (P<0.001). Daily frequency of pan-tobacco chewing was the strongest predictor of risk in males, with a relative risk of 15.07 associated with chewing ten or more quids per day. The corresponding relative risk among females was 13.69. In males a relative risk of 3.20 was associated with smoking more than 20 bidis per day, and relative risks of 2.62 and 3.90 were associated with regular use of alcohol and snuff respectively. Surprisingly high relative risks were observed in association with occasional use of pan-tobacco, bidi, cigarettes, alcohol and snuff. A stepwise logistic regression analysis yielded four predictors: pan-tobacco daily frequency, duration of bidi use, and alcohol and snuff use (regular versus never). There were also significantly elevated risks associated with occasional indulgence in these four habits. Total lifetime exposure was no better at predicting risk than daily frequency or duration of habits.Cancer of the gingiva is an uncommon malignancy in many parts of the world. The highest incidence rates which are of the order of 2.3 per 100,000 population per year are reported from the Indian subcontinent (Muir et al., 1987). In many parts of India it constitutes 10-15% of all intra oral cancers and 2-3% of all incident cancers (National Cancer Registry Project, India, 1982-1985Krishnan Nair et al., 1988).The epidemiology of gingival carcinoma has been studied previously as part of a case spectrum consisting of other intra oral and head and neck cancers (Sanghvi et al., 1955;Shanta & Krishnamoorthy, 1959, 1963Wahi et al., 1965;Jussawalla & Deshpande, 1971;Jayant et al., 1977: Notani, 1988 Pan chewing, pan-tobacco chewing, bidi smoking, cigarette smoking, alcohol and nasal snuff inhalation were the habits ascertained for the cases and controls. Pan chewing is defined as chewing of a quid containing fresh betel leaves (Piper betle), arecanut (Areca catechu) and aqueous lime (calcium hydroxide). Locally cured tobacco leaves and/or stem are added to the quid in pan-tobacco. Bidi is a local cigarette containing 0.5 g of coarse tobacco dust rolled in a dried temburni leaf. The alcohol predominantly consumed is either 'toddy' (a locally fermented distilled sap from palm trees) or another locally brewed liquor called 'arrack' (approximately 40% ethanol) or both. Consumption of wine, beer, brandy, whiskey, gin and rum, collectively known as 'foreign liquors' is uncommon. The snu...

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Section: Combinedmentioning

confidence: 80%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Tobacco chewing, alcohol and nasal snuff in cancer of the gingiva in Kerala, India

Sankaranarayanan

Duffy²,

Padmakumary³

et al. 1989

Br J Cancer

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“…In India, cancers of the upper alimentary tract, viz., oral, pharyngeal and oesophageal cancers, have received major attention in epidemiological studies. Sanghvi, Rao and Khanolkar (1955) brought out the role of bidi (small, hand rolled Indian cigarette) smoking in addition to chewing of tobacco in these cancers. Several studies carried out subsequently have confirmed these findings (Shanta and Krishnamurthy, 1963;Hirayama, 1966;Wahi, 1968;Jussawalla and Deshpande, 1971).…”

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confidence: 99%

A Retrospective Study of Lung Cancer in Bombay

Notani¹,

Sanghvi²

1974

Br J Cancer

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Summary.-This is a retrospective study of 520 patients with lung cancer, seen at the Tata Memorial Hospital between 1963 and 1970. Matched controls were obtained from those patients who came to the hospital within the same period and who were diagnosed as not having cancer. The patients and controls were matched for age, sex and community. As reported in other studies, an association was found between smoking habit and lung cancer. The relative risk of all types of smokers to non-smokers is 2*45, of bidi smokers 2-64 and of cigarette smokers 2-23. There is a preponderance of the group of epidermoid carcinomata among smokers as against adenocarcinomata. The probable reasons for the reported low incidence of lung cancer in this population have been discussed.

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“…The high incidence of buccal cavity and pharyngeal cancers in Greater Bombay, and indeed throughout India, is believed to be associated with the habit of chewing betel nut with tobacco, lime and other ingredients, especially in association with a spicy diet, poor oral hygiene and malnutrition (Khanolkar, 1959;Paymaster, 1962;Sanghvi, Rao and Khanolkar, 1955;and Shanta and Krishnamurthi, 1959).…”

Section: Observations On Selected Sitesmentioning

confidence: 99%