Frequency and association of self-reported oral cancer among individuals with type 2 diabetes at a tertiary care diabetes centre in South India - A retrospective study

Abstract

AimTo assess the frequency of self-reported oral cancer and associated factors among individuals with type 2 diabetes (T2D) at a tertiary care diabetes centre in South India. MethodsIndividuals with T2D who reported that they had oral cancer were included from the Diabetes Electronic Medical Records (DEMR) database. To assess the association of oral cancer with T2D, a retrospective nested case-control study design was adopted. Individuals with T2D and oral cancer diagnosed after the diagnosis of T2D (n = 78) were considered ‘cases’, while T2D without oral cancer were considered ‘controls’ (312) [in a ratio of 1:4 for cases and controls]. The cases and controls were matched for age, gender and duration of diabetes. Logistic regression was used to model predictors of oral cancer in T2D patients. ResultsOral cancer was reported in 78 out of 379,138 (0.02%) individuals with T2D registered at the centre. Logistic regression analysis showed that a HbA1c value ≥ 9% had a significant association with oral cancer with an odds ratio of 2.3 (95% CI: 1.2–4.6) after adjusting for confounding factors. Among individuals with T2D, higher frequency of oral cancer prevalence and risk was observed among those who used any form of tobacco (32.6%, OR = 2.52, 95% CI: 1.5–4.3), consumed alcohol (29.2%, OR = 2.01, 95% CI: 1.2–3.3), and those with hypertension (23.9%, OR = 2.05, 95% CI: 1.2–3.6) and hypertriglyceridemia (24.7%, OR = 1.66, 95% CI: 1.01–2.7). Significant independent predictors of oral cancer among T2D were tobacco use (OR = 2.06, 95% CI: 1.1–4.00), high HbA1c (OR = 1.3, 95% CI: 1.03–1.5), hypertension (OR = 2.3, 95% CI: 1.3–4.2) and insulin use (OR = 1.8, 95% CI: 1.03–3.2). ConclusionsRegular dental check-ups as part of the follow-up for individuals with T2D will identify and diagnose oral cancer earlier. Further research is required to assess the physiological and biological mechanisms leading to oral cancer in individuals with T2D.