Smokeless tobacco use and risk of oral cavity cancer

Shah Zeb Khan,Abubaker Shahid,Misbah Masood,Irfan Ullah Khan,Hasan Nisar,Ismat Fatima,Ahmed Farooq

doi:10.3906/sag-1809-11

Abstract

Background/aim Smokeless tobacco has been associated with oral cavity cancer for several decades. The incidence of oral cavity cancer is higher in some parts of the world especially South and South-East Asia including Pakistan. The aim of current study was to evaluate the risk of oral cavity cancer among smokeless tobacco users in our country.Materials and methods A case-control study was conducted between November 2016 and September 2017. Patients diagnosed with oral cavity cancer receiving treatment were included as cases and the attendants of various cancer patients visiting the hospital during the study period were included in the study as controls. Odds ratios (OR) and 95% confidence intervals (CI) were calculated and all reported P-values were considered significant at < 0.05. Results The crude OR for the “ever smokeless tobacco users” among cases and controls came out to be 4.98 (95%CI; 2.76–9.01). The OR for snuff users among cases and controls was 4.82 (95%CI; 2.37–9.80) and that for betel leaf users was 4.42 (95%CI; 1.66–11.91) after adjusting for smoking and age.ConclusionOur study provided strong evidence for snuff and betel leaf to be independent risk factors for oral cavity cancer.

Highlights

International Agency for Research on Cancer (IARC) in 2006 declared that smokeless tobacco (SLT) is carcinogenic in human beings, causing cancer of the oral cavity and pancreas
Wide variability amongst geographic regions in the type and extent of disease caused by the use of smokeless tobacco was observed by IARC and disease dissimilarities were attributed to the large differences in the concentrations of carcinogens in the tobacco used in different regions [1,2,3,4,5]
To ensure relative ethnic and socioeconomic similarity with cases, a control was defined as a person aged 19 years and above not having oral cavity cancer, who visited INMOL as an attendant of a case selected for our study

Summary

Introduction

International Agency for Research on Cancer (IARC) in 2006 declared that smokeless tobacco (SLT) is carcinogenic in human beings, causing cancer of the oral cavity and pancreas. Smokeless tobacco has capricious modes of consumption from chewable tobacco not mixed with any other ingredient to a mixture of tobacco with other ingredients such as betel leaf (locally called “paan”), snuff (locally called “naswar”), supari, chalia, and Mishri [6]. It contains a number of carcinogens including non-volatile alkaloid-derived tobacco-specific N-nitrosamine and N-nitrosamino acids. Pakistan is one of the countries where the use of SLT is a culturally acceptable habit. Studies from Karachi demonstrate that snuff is a major contributor in the aetiology of oral cavity cancer in Pakistan [8]

Methods

Results

Conclusion