Abstract
Tobacco and betel quid are the most common cause of oral cancer in India. Very often oral cancers are preceded by a visible oral precursor lesion called as potentially malignant disorder (PMD). Aim: The aim of this study was to assess the prevalence of oral PMDs associated with habits in urban and rural areas of Puducherry Union territory, India. Methods: A cross-sectional descriptive study in urban and rural areas of Puducherry was conducted. The study group comprised of 450 patients with positive history of oral habits. A standard structured questionnaire was designed to record information about demographic details, socioeconomic status, type, duration and frequency of habits followed by clinical oral examination by single trained and calibrated examiner to detect the presence of PMD. Statistical analysis used: EpiData software (version 3.1). Descriptive statistics were presented for all variables. Pearson’s Chi-Square test and adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated to estimate the suspected risk factors for PMD by using multivariate logistic regression analysis. P-value of ≤ 0.05 was considered to be statistically significant. Results: Prevalence of habit associated oral PMD was 64.2%. Females were more prone to develop PMDs (68.3%) as compared to males (62.8%). PMD was more common in the age group of 51-60 years (69.2%). Smoking with alcohol consumption was the most common oral habit. Habits, socio-economic status and diet were significantly associated with development of oral PMDs in our study population. Multivariate logistic regression analysis showed that chronic betel quid chewing and smoking were significant risk factors for PMD. Increased frequency of vegetable consumption reduced the risk of PMD. Conclusions: Oral PMD were observed in more than half of the subjects with oral habits in Puducherry. Clearly, there is an increased risk of PMD with increased duration of tobacco and betel quid use in this region. Patients and public need to be educated regarding PMD and encouraged to quit habits so as to prevent high risk population from developing cancer.
Highlights
Among the modern epidemics, cancer is one of the major causes of mortality in developing countries[1]
Among 450 participants in our study, Potentially Malignant Disorders (PMD) was identified among 288 individuals (64.2%) which is consistent with the reports by Kadashetti et al.[1] in Maharashtra (65%)
The wide variation among the prevalence rates of PMD may be attributed to the changing trends in oral habits in various parts of the country and other associated risk factors like cultural, socioeconomic and environmental factors
Summary
Cancer is one of the major causes of mortality in developing countries[1]. India has one of the highest rates of oral cancer due to life style related habits such as smoking, betel quid chewing and alcohol. Oral cancers are often preceded by clinically evident precursor lesions called as Potentially Malignant Disorders (PMD). The term PMD introduced by WHO in 2007, conveys that not all lesions and conditions described under this term may transform to cancer, instead there is a family of morphological alterations among which some may have an increased potential for malignant transformation[2]. The overall prevalence of PMD worldwide is reported as 4.47%3. Sun exposure, micronutrient deficiency and socio-economic status are independent risk factors for development of oral PMDs
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