Smokeless tobacco use and oral neoplasia among urban Indian women.

Abstract

Oral cavity cancers are fourth most common cancers among Indian women. The objectives were to create cancer awareness (CA) and screen tobacco-using women for oral cavity cancers. A community-based CA and screening programme was conducted among women in Mumbai, India. The tobacco-using women participated in CA and oral cavity screening by oral visual inspection (OVI). All screen-positive women were referred to nodal hospital and assisted for diagnostic confirmation and treatment completion. Twelve slum clusters comprising of 138,383 population and 13,492 tobacco-using women have been covered. Among them, 11,895 (88.2%) participated in CA and 11,768 (87.2%) in OVI. A total of 377 (3.2%) women were screened positive, 275 (72.9%) complied with referral and 207 oral precancers [173 leukoplakia, 9 erythroplakia, 3 erythroleukoplakia and 41 sub-mucus fibrosis (SMF) including 35 women with multiple precancers] and 7 oral cancers were diagnosed. The detection rate of oral precancerous lesions and oral cancers was 17.6 and 0.6 per 1,000 screened women. Thirty-five women had multiple oral precancerous lesions. The results of multivariate analysis indicate dose-response relationship between tobacco use and risk of oral precancers. Good participation rates (>85%) for cancer awareness and OVI were seen among urban slum women in India. Many oral precancer and cancer cases were detected and were managed at the nodal hospital.