Abstract
Background
Although oral cancer accounts for 2.1% of all cancer cases globally, it is surfacing as a major public threat in India. Oral cancer figures among three most common types of cancer in the Indian subcontinent, with an incidence rate of 30%. The increased availability and use of smokeless tobacco and betel quid in the recent years have further aggravated the situation. The scarcity of reports on the contribution of such risk factors in oral cancer incidence remains a prime concern. In this perspective, the association between smokeless tobacco and cancer of gingivobuccal sulcus was investigated.
Method
The medical records of 249 patients with cancer of gingivobuccal sulcus, attending the BRAIRCH, AIIMS, New Delhi, were retrospectively examined from 2009-2016. Demographic and clinical data including history of addictions (smoking, smokeless tobacco) were collected and patients were staged according to the 8thAJCC Cancer Staging (2017).
Results
Smokeless forms of tobacco were more prevalent among the patients (50.7%), in contrast to smoked tobacco (19.53%), while 29.77% were reported to consume both forms. A higher proportion of patients with smokeless tobacco addiction were diagnosed with advanced stages of cancer (56.9% in Stage III/IV). These rates were even higher (65.6%) in patients using both smokeless and smoked tobacco.
Conclusions
A strong association was observed between smokeless tobacco and gingivobuccal sulcus cancer, particularly in patients who kept the tobacco in the buccal vestibule after chewing, to suck, sometimesovernight. Elucidating the potential risk factors can be a key approach to design effective intervention programs to combat the growing pandemic of oral cancer in India.
Oral cancer staging established by magnetic resonance imaging
