Risk Assessment of Smokeless Tobacco among Oral Precancer and Cancer Patients in Eastern Developmental Region of Nepal

ABSTRACT Aim To study, whether the consumption of regular tea/coffee (methylxanthines) increases the risk of oral cancer in patients with smoking and smokeless tobacco habits. Materials and methods This study was conducted on a total of 90 oral cancer and precancerous patients, from western Maharashtra (India) males in the age group of 20 to 45 years who were with smoking and smokeless tobacco habits; also regular tea/coffee consumers were subjected to biochemical parameters such as aspartate transaminase (AST) and alanine transaminase (ALT) from saliva and serum of patients with oral precancer (submucous fibrosis, leukoplakia) and oral cancer patients and compared with 90-age and sex-matched controls. Individuals consent was taken to measure their biochemical parameters, by using Hafkenscheid method in whole saliva and serum. Statistical analysis of variance (ANOVA) with Tukey's correction for multiple group comparisons was performed using Student t-test. Results Results show, that a statistically significant increase in value (p < 0.05) in ALT, AST in both saliva and serum was observed in precancerous and oral cancer patients among the study group as compared to the control group. Conclusion In the present study, there was increase in the levels of ALT, AST enzymes in both saliva and serum levels in the study group as compared to the control group which was statistically significant (p < 0.05) suggesting that long-term exposure of methylxanthines results in impairment of salivary gland antioxidant system which may affect the anticarcinogenic action of saliva. Clinical significance Oral fluids may be utilized effectively to study the variations in the biochemical constituents of saliva of leukoplakia, submucous fibrosis and oral cancer patients. How to cite this article Zubairy YF, Patil VW, Benjamin T, Jangam D, Bijle MNA, Patil S. Effect of Methylxanthines (Coffee/ tea Consumers) on Oral Precancer and Oral Cancer Patients with Smoking and Smokless Tobacco Habits. J Contemp Dent Pract 2012;13(6):745-748.

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VTE risk assessment in cancer

Onkologische Welt ◽

10.1055/s-0038-1624994 ◽

2016 ◽

Vol 07 (01) ◽

pp. 20-25

Author(s):

I. Pabinger ◽

C. Ay

Keyword(s):

Risk Assessment ◽

Cancer Patients ◽

Medical Oncology ◽

Clinical Importance ◽

Cancer Surgery ◽

Ambulatory Setting ◽

Oncology Patients ◽

Related Factors ◽

Risk Assessment Models ◽

Increased Risk

SummaryVenous thromboembolism (VTE) in patients with cancer is associated with an increased morbidity and mortality, and its prevention is of major clinical importance. However, the VTE rates in the cancer population vary between 0.5% - 20%, depending on cancer-, treatment- and patient-related factors. The most important contributors to VTE risk are the tumor entity, stage and certain anticancer treatments. Cancer surgery represents a strong risk factor for VTE, and medical oncology patients are at increased risk of developing VTE, especially when receiving chemotherapy or immunomodulatory drugs. Also biomarkers have been investigated for their usefulness to predict risk of VTE (e.g. elevated leukocyte and platelet counts, soluble P-selectin, D-dimer, etc.). In order to identify cancer patients at high risk of VTE and to improve risk stratification, risk assessment models have been developed, which contain both clinical parameters and biomarkers. While primary thromboprophylaxis with lowmolecular- weight-heparin (LMWH) is recommended postoperatively for a period of up to 4 weeks after major cancer surgery, the evidence is less clear for medical oncology patients. Thromboprophylaxis in hospitalized medical oncology patients is advocated, and is based on results of randomized controlled trials which evaluated the efficacy and safety of LMWH for prevention of VTE in hospitalized medically ill patients. In recent trials the benefit of primary thromboprophylaxis in cancer patients receiving chemotherapy in the ambulatory setting has been investigated. However, at the present stage primary thromboprophylaxis for prevention of VTE in these patients is still a matter of debate and cannot be recommended for all cancer outpatients.

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Impact of comorbidity assessment methods to predict non-cancer mortality risk in cancer patients: a retrospective observational study using the National Health Insurance Service claims-based data in Korea

BMC Medical Research Methodology ◽

10.1186/s12874-021-01257-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sanghee Lee ◽

Yoon Jung Chang ◽

Hyunsoon Cho

Keyword(s):

Risk Assessment ◽

Health Insurance ◽

Cancer Patients ◽

National Health Insurance ◽

National Health ◽

Cancer Mortality ◽

Prediction Models ◽

Assessment Methods ◽

Chronic Obstructive ◽

Mortality Risks

Abstract Background Cancer patients’ prognoses are complicated by comorbidities. Prognostic prediction models with inappropriate comorbidity adjustments yield biased survival estimates. However, an appropriate claims-based comorbidity risk assessment method remains unclear. This study aimed to compare methods used to capture comorbidities from claims data and predict non-cancer mortality risks among cancer patients. Methods Data were obtained from the National Health Insurance Service-National Sample Cohort database in Korea; 2979 cancer patients diagnosed in 2006 were considered. Claims-based Charlson Comorbidity Index was evaluated according to the various assessment methods: different periods in washout window, lookback, and claim types. The prevalence of comorbidities and associated non-cancer mortality risks were compared. The Cox proportional hazards models considering left-truncation were used to estimate the non-cancer mortality risks. Results The prevalence of peptic ulcer, the most common comorbidity, ranged from 1.5 to 31.0%, and the proportion of patients with ≥1 comorbidity ranged from 4.5 to 58.4%, depending on the assessment methods. Outpatient claims captured 96.9% of patients with chronic obstructive pulmonary disease; however, they captured only 65.2% of patients with myocardial infarction. The different assessment methods affected non-cancer mortality risks; for example, the hazard ratios for patients with moderate comorbidity (CCI 3–4) varied from 1.0 (95% CI: 0.6–1.6) to 5.0 (95% CI: 2.7–9.3). Inpatient claims resulted in relatively higher estimates reflective of disease severity. Conclusions The prevalence of comorbidities and associated non-cancer mortality risks varied considerably by the assessment methods. Researchers should understand the complexity of comorbidity assessments in claims-based risk assessment and select an optimal approach.

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