Assessment of Betel Quid Habits and Risk of Precancerous Oral Lesions Among Paniya Tribes of Wayanad, India - A Cross-Sectional Study

Abstract

Background: Betel quid habits in India is widely prevalent and responsible for increased incidence of head and neck cancer in the country. Head and neck cancer is a major public health problem among Paniya tribes, a marginalized tribal group in Kerala state, India. Previous studies among Paniya tribals in Wayanad have documented a high prevalence of betel quid habit. Oral leukoplakia (OL) and oral submucous fibrosis (OSF) are the most common oral mucosal diseases that have a very high malignant transformation rate. Aim: Aim of this study was to evaluate the risks imposed by betel quid habits in the development of oral leukoplakia and oral submucous fibrosis among Paniya tribes of Wayanad. Methods: A cross-sectional study was carried out in 300 residents between September 01, 2009 and March 31, 2017 using a structured questionnaire containing details of betel quid habits and socio-demographic details. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and SPSS 16 software. Results: In the 300 subjects, the mean age was 32.4 ±SD 11.4 years, gender distribution (57.5% males vs. 42.5% females). 32.5% out of the study population were betel quid chewers (46.5% of males and 14.6% of females). The prevalence of OL and OSF was 12.9% and 13.02%, respectively among betel quid chewers. Conclusion: Awareness of head and neck cancer by betel quid habits varied with socioeconomic status among Paniya tribes of Wayanad. Despite their awareness of tobacco chewing as a risk factor for head and neck cancer, most of them still continue to chew. There is an urgent need to develop and implement culturally appropriate awareness-raising activities to target betel quid habit.