Abstract
Background: Oral cancer in Sudan has high incidence rate due to the use of Toombak , a home- made smokeless tobacco, rich in tobacco specific nitrosamines .There have been calls for continuous monitoring on toombak users to discover very early the carcinogenic changes to avoid mortality, and morbidity.
 Objective: The purpose of this study was to assess technically, and financially affordable methodologies, that are reliable, reproducible, sensitive, specific and cost effective valid for use in mass screening amongst the high risk groups. (The toombak users).The present study was done to evaluate the levels of copper, zinc and magnesium in serum of toombak dippers. 
 Materials and Methods: The levels of copper, zinc, and magnesium were estimated in the serum of 150 toombak dippers . The values were compared with 50 normal age matched, healthy control subjects and 50 patients with oral squamous cell carcinoma, using Atomic absorption spectrophotometry.
 Results: There was significant difference of the mean serum copper, zinc, and magnesium levels of toombak dippers when compared to the normal controls. In oral cancer patients there was significant difference in the copper, zinc, and magnesium levels. Copper level was found increased gradually starting from control through toombak dippers to oral squamous cell carcinoma patients , while the level of zinc and magnesium was found decreased in the same sequence.
 Conclusion: Serum may be used as a potential diagnostic tool, which can be efficiently employed to evaluate the copper, zinc and magnesium levels in Sudanese snuff dippers for population based mass screening .Serum trace elements levels could be used as potential diagnostic markers for early changes caused by toombak dipping.
 Keywords: Atomic absorption spectrophotometry, copper, magnesiumm , zinc, oral squamous cell carcinoma, tobacco specific nitrosamines, serum , toombak.
Highlights
Oral Cancer is the 6th most common Cancer in the world, and the most common cancer in head and neck.500,000 new cases are added annually worldwide, with increasingHow to cite this article: Abdel Azim Alsanousi, Abdel Raouf Ahmed, and GadAllah Modawe (2019) “Quantitative Analysis of Serum Levels of Trace Elements in Sudanese Snuff Dippers,” Sudan Journal of Medical Sciences, vol 14, issue no. 3, pages 152–161
Oral cancer is the 5th most common cancer in the Sudan with incidence rate of (920/year) comprising 9 % of the cases reported annually in Africa. This is strongly attributed to the use of local type of snuff known as Toombak, a very popular material in the Sudanese community [3]. toombak, is home-made from finely ground leaves of Nicotiana rustica, a tobacco species with a high content of nicotine and minor alkaloids
The present study was done to evaluate the levels of copper, zinc and magnesium in serum of toombak dippers
Summary
Oral Cancer is the 6th most common Cancer in the world, and the most common cancer in head and neck.500000 new cases are added annually worldwide, with increasingHow to cite this article: Abdel Azim Alsanousi, Abdel Raouf Ahmed, and GadAllah Modawe (2019) “Quantitative Analysis of Serum Levels of Trace Elements in Sudanese Snuff Dippers,” Sudan Journal of Medical Sciences, vol 14, issue no. 3, pages 152–161. Oral cancer is the 5th most common cancer in the Sudan with incidence rate of (920/year) comprising 9 % of the cases reported annually in Africa This is strongly attributed to the use of local type of snuff known as Toombak, a very popular material in the Sudanese community [3]. Oral cancer in Sudan has high incidence rate due to the use of Toombak, a home- made smokeless tobacco, rich in tobacco specific nitrosamines.There have been calls for continuous monitoring on toombak users to discover very early the carcinogenic changes to avoid mortality, and morbidity. Conclusion: Serum may be used as a potential diagnostic tool, which can be efficiently employed to evaluate the copper, zinc and magnesium levels in Sudanese snuff dippers for population based mass screening.Serum trace elements levels could be used as potential diagnostic markers for early changes caused by toombak dipping
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