Incidence Of Oral Cancer Research Articles

To Estimate and Compare the Level of Serum Immunoglobulin A in Patients of Oral Submucous Fibrosis, Leukoplakia, and Control Group.

To estimate and compare the level of serum immunoglobulin A in patients of oral submucous fibrosis (OSMF), leukoplakia, and control group. OSMF is a well-recognized potentially malignant condition in the oral cavity, and a transformation rate as high as 7.6% over a period of 10 years has been reported from India. Leukoplakia has evolved as a clinico-pathologic concept over many years, with the current clinical designation being accepted worldwide. Quantia IgA is a turbidometric immunoassay for the detection of IgA in human serum and is based on the principle of agglutination reaction. The test specimen is mixed with the activation buffer (R1) and then with antihuman IgA reagent (R2) and allowed to react. For the estimation of serum IgA, 500 μl of Quantia IgA activation buffer R1 is taken in a clean test tube. Serum sample is diluted in the ratio of 1:5 with normal saline. Ten microliters of diluted serum sample are added to R1. After incubation for 10 min, 50 μl of R2 is added, which is Quantia IgA antihuman IgA reagent to the sample, and the reading is recorded at wavelength 340 nm at 37°C. The level of IgA will be estimated by a semi-automatic biochemical analyzer machine and then data analysis will be done. The immunologic alterations observed by us in OSMF and leukoplakia are almost similar or nearer to the alterations observed in oral cancer, so it is reasonable to assume that OSMF and leukoplakia can be an intermediate stage in the transformation process of a normal cell to oral malignancy. Prevention and early detection is the best way to reduce the incidence and mortality of premalignant disorders and oral cancer. There are many ways and methods of early detection of premalignant disorders and oral cancer, and the immunological method is one of them.

Preoperative Serum Selenium Concentrations and Disease-Specific Survival in Patients With Oral Cancer: A Long-Term Follow-Up Study

BackgroundSerum selenium (Se) concentration has been reported to be associated with the incidence of oral cancer. The association between serum Se and long-term survival in oral cancer patients is still unclear. PurposeThe purpose of this study is to measure the association between serum Se and disease-specific survival (DSS). Study design, setting, and sampleThis was a single-center, prospective cohort study conducted at the First Affiliated Hospital of Fujian Medical University (Fujian province, China) from September 2011 to December 2018. The inclusion criteria were patients with newly diagnosed primary oral cancer confirmed by histology. The exclusion criteria were patients with recurrent oral cancer or metastatic cancer. Predictor VariableThe predictor variable is the preoperative serum Se concentration measured using inductively coupled plasma-mass spectrometry (ICP-MS). Outcome VariablesThe primary outcome variable is DSS calculated from the date of diagnosis to date of death due to oral cancer or end of follow-up, whichever occurred first. CovariatesThe covariates were age, sex, occupation, education level, BMI, surgery therapy, adjuvant therapy, TNM stage, pathological grading. AnalysesKaplan-Meier survival analysis, Cox proportional hazards regression and restricted cubic spline regression were utilized. P-value < 0.05 was significant. ResultsThe sample was composed of 235 subjects with a median age of 59 years (ranged from 20 to 80 years) and 142 (60.43%) were male. The median follow-up was 54.90 months (interquartile range: 35.47). Se levels were associated with DSS (unadjusted HR=0.70, 95% CI: 0.54-0.91) suggesting that higher levels of Se are associated with longer or improved DSS. After adjustment of age, sex, occupation, education level, residence, TNM stage, pathological grading, surgery therapy, radiotherapy and chemotherapy, patients with higher serum Se had a better DSS (aHR=0.67, 95% CI: 0.49-0.92). Of note, we found that the association between serum Se and DSS was observed only in patients with radiotherapy (aHR= 0.49, 95% CI: 0.33-0.73). And the protective effect of radiotherapy on survival was only observed in patients with higher Se concentrations (aHR=0.36, 95% CI: 0.20-0.63). Additionally, there was a multiplicative interaction between Se and radiotherapy on the prognosis of oral cancer patients (Pinteraction<0.01). Conclusion and RelevanceOur findings suggest that a high Se concentration might contribute to better DSS among oral cancer patients, and the effect may partly depend on radiotherapy treatment. Given these findings, additional research should focus on the role of Se in DSS among oral cancer patients and the interaction with radiotherapy.

Enhanced laser-induced fluorescence and Raman spectroscopy with gold nanoparticles for the diagnosis of oral squamous cell carcinoma

BackgroundThe incidence, mortality, and recurrence rates of oral cancer are high worldwide. It is a common and aggressive type of tumor. Owing to the challenges associated with early illness diagnosis, squamous cell carcinoma, a kind that is prevalent of oral cancer, has an unacceptably high fatality rate. The management of the condition and the prevention of cancer, on the other hand, depend greatly on early detection. Therefore, alternative methods for the treatment and early diagnosis are essential for oral cancer. The detection of tongue squamous cell carcinoma is aided by coupled surface plasmon resonance, which can occur in gold nanoparticles (AuNPs). Compared to the currently utilized imaging contrast chemicals, AuNPs are more biocompatible and capable of targeting specific surface molecules. In the current study, AuNPs were synthesized in one step via citrate reduction and applied to tongue samples of a Caucasian man's Homo sapiens (Squamous cell carcinoma from ATCC cell-lines) in order to improve early detection using and laser-induced fluorescence and Raman spectroscopy.ResultsUV–visible spectroscopy, Zeta potential, TEM, and FTIR spectroscopic technique were used to characterize the synthesized nanoparticles. The synthesized AuNPs measured 13 ± 3 nm with uniform size distribution and high stability. Results demonstrate the significance of AuNPs in improving the identification of tongue squamous cell carcinoma.ConclusionObtained results revealed that the use of AuNPs modifies the emitted spectra in the two employed spectroscopic techniques and provides more significant receiver operating characteristic curve parameters, hence a higher detection rate of cancer.

CXCL9 mediating the effect of thyroid disorders on oral and oropharyngeal cancer risk: A mediation Mendelian randomization study

IntroductionThe established association between thyroid disorders (TD) and its two main subtypes—hyperthyroidism and hypothyroidism—and the incidence of oral and oropharyngeal cancer (OCPC) has been substantiated. However, the direct causal relationship and potential intermediary mechanisms linking these conditions have not been clearly defined in prior studies. Material & methodsThis study employed univariate Mendelian randomization (MR) analysis to explore those relationship. Instrumental variables from genome-wide association study (GWAS) datasets for TD (n = 218,792), hyperthyroidism (n = 460,499), hypothyroidism (n = 213,990), and OCPC (n = 12,619), along with 41 intermediary inflammatory cytokines (n = 8293), were analyzed. Inverse variance weighting (IVW) method assessed the causal relationships, while summary MR analysis with pQTL datasets from decode and 91 inflammatory cytokines explored the cytokines' roles as biomarkers and therapeutic targets for OCPC. Multivariable MR (MVMR) analysis quantified the mediation effect of these cytokines in the TD-OCPC relationship. ResultsUVMR analysis provided strong evidence for a causal relationship between TD (OR = 1.376, 95 % CI = 1.142–1.656, p = 0.001), hyperthyroidism (OR = 1.319, 95 % CI=1.129–1.541, p = 0.001), hypothyroidism (OR = 1.224, 95 % CI = 1.071–1.400, p = 0.003), and the risk of OCPC. CXCL9 was identified as a significant intermediary in mediating the risk of OCPC from TD and its two subtypes (OR = 1.218, 95 % CI = 1.016–1.461, P = 0.033), suggesting its potential as a predictive biomarker for OCPC. MVMR analysis further revealed that CXCL9 mediated 7.94 %, 14.4 %, and 18 % of the effects of TD, hyperthyroidism, and hypothyroidism on OCPC risk, respectively. DiscussionThis study not only elucidated the potential causal relationships between TD including its two subtypes and OCPC risk, but also highlighted CXCL9 as a pivotal mediator in this association.

Multifunctional curcumin mediated zinc oxide nanoparticle enhancing biofilm inhibition and targeting apoptotic specific pathway in oral squamous carcinoma cells.

Oral health remains a significant global concern with the prevalence of oral pathogens and the increasing incidence of oral cancer posing formidable challenges. Additionally, the emergence of antibiotic-resistant strains has complicated treatment strategies, emphasizing the urgent need for alternative therapeutic approaches. Recent research has explored the application of plant compounds mediated with nanotechnology in oral health, focusing on the antimicrobial and anticancer properties. In this study, curcumin (Cu)-mediated zinc oxide nanoparticles (ZnO NPs) were synthesized and characterized using SEM, EDAX, UV spectroscopy, FTIR, and XRD to validate their composition and structural features. The antioxidant and antimicrobial activity of ZnO-CU NPs was investigated through DPPH, ABTS, and zone of inhibition assays. Apoptotic assays and gene expression analysis were performed in KB oral squamous carcinoma cells to identify their anticancer activity. ZnO-CU NPs showcased formidable antioxidant prowess in both DPPH and ABTS assays, signifying their potential as robust scavengers of free radicals. The determined minimal inhibitory concentration of 40µg/mL against dental pathogens underscored the compelling antimicrobial attributes of ZnO-CU NPs. Furthermore, the interaction analysis revealed the superior binding affinity and intricate amino acid interactions of ZnO-CU NPs with receptors on dental pathogens. Moreover, in the realm of anticancer activity, ZnO-CU NPs exhibited a dose-dependent response against Human Oral Epidermal Carcinoma KB cells at concentrations of 10µg/mL, 20µg/mL, 40µg/mL, and 80µg/mL. Unraveling the intricate mechanism of apoptotic activity, ZnO-CU NPs orchestrated the upregulation of pivotal genes, including BCL2, BAX, and P53, within the KB cells. This multifaceted approach, addressing both antimicrobial and anticancer activity, positions ZnO-CU NPs as a compelling avenue for advancing oral health, offering a comprehensive strategy for tackling both oral infections and cancer.

Lip, oral and oropharyngeal cancer incidence among Aboriginal and Torres Strait Islander Peoples: First reportfrom Australian population-based cancer registry, 1999-2018.

The Australian Burden of Disease Study has shown that cancer is the single most important entity responsible for the greatest cause of health burden in Australia. Unfortunately, Aboriginal and Torres Strait Islander peoples experience a greater burden of this disease, with cancer of the lung, breast, bowel and prostrate being the most common. Lip, oral cavity and pharyngeal cancer incidence is rapidly rising globally and is now the sixth most common cancer in Australia. This paper aims to summarize, for the first time, the incidence and prevalence trends of lip, oral cavity and pharyngeal cancers in Aboriginal and Torres Strait Islander Australians. Data were obtained from the Australian Cancer Database (ACD), which is compiled at the Australian Institute of Health and Welfare (AIHW) from 1999 to 2018 to estimate the incidence and prevalence of certain head and neck cancers (ICD-10 codes C00-C10, C14). The other variables requested were age groups and sex. Results were stratified by ICD-10 code, sex and age group at diagnosis and time period (i.e. grouped years of diagnosis). The total incidence of lip, oral cavity and pharyngeal cancers increased by 1.3 times from 1999 to 2008 (107/100 000) to 2009-2018 (135/100 000). The overall 5-year prevalence of lip, oral cavity and pharyngeal cancers was 0.17% (0.24% for men and 0.09% for women). The significantly increased incidence of lip, oral cavity and pharyngeal cancers in Aboriginal and Torres Strait Islander peoples in Australia is concerning and should be explored. A targeted, comprehensive and culturally safe model of care for Aboriginal and Torres Strait Islander peoples with lip, oral cavity and pharyngeal cancers is imperative.

Trends and predictors of unplanned hospitalization among oral and oropharyngeal cancer patients; an 8-year population-based study

PurposeThe incidence of oral cancers, particularly HPV-related oropharyngeal cancer, is steadily increasing worldwide, presenting a significant healthcare challenge. This study investigates trends and predictors of unplanned hospitalizations for oral cavity cancer (OCC) and oropharyngeal cancer (OPC) patients in the province of Alberta, Canada. MethodsThis retrospective, population-based, cohort study used administrative data collected from all hospitals in the province. Using the Alberta Cancer Registry (ACR), a cohort of adult patients diagnosed with a single primary OCC or OPC between January 2010 and December 2017 was identified. Linking this cohort with the Discharge Abstract Database (DAD), trends in hospitalizations, primary diagnoses, and predictors of unplanned hospitalization (UH) and 30-day unplanned readmission were analyzed. ResultsOf 1,721 patients included, 1,244 experienced 2,228 hospitalizations, with 48 % being categorized as UH. The UHs were significantly associated with a higher mortality rate, 18.5 % as compared to 4.6 % for planned, and influenced by sex, age groups, comorbidities, cancer types, stages, and treatment modalities. The rate of UH per patient decreased from 0.69 to 0.54 visits during the study period (P = 0.02). Common diagnoses for UH were palliative care and post-surgical convalescence, while surgery-related complications such as infection and hemorrhage were frequent in 30-day unplanned readmissions. Predictors of UH included cancer stage, material deprivation, and treatment, while cancer type and comorbidity predicted readmissions. ConclusionThe rate of UHs showed a noteworthy decline in this study, which could be a result of enhanced care coordination. Furthermore, identified primary diagnosis and predictors associated with UHs and readmissions, provide valuable insights for enhancing the quality of care for cancer patients.

Epidemiology of oral cancer in South and South-East Asia: Incidence and mortality.

This study provides an epidemiological description of cancer in the lip, oral cavity, and oropharynx in the South and South-East Asia region. The number of new cases and deaths was extracted from the GLOBOCAN 2020 and the CI5 series. We present age-standardized incidence and mortality rates per 100,000 inhabitants. To assess temporal trends, we estimated the annual percent change. The incidence rates (ASR) for lip and oral cavity cancer in South and South-East Asia were highest in Taiwan (30.2), Sri Lanka (16.5), India (14.8), and Pakistan (13.2) among males. For oropharyngeal cancer, the highest rates were found in Taiwan (4.7), Bangladesh, Sri Lanka, and India (4.3, 2.9, and 2.6, respectively). Incidence rates were consistently higher in males compared to females. Overall, trends in lip and oral cavity cancer incidence were either stable or decreasing in most of the populations evaluated. In India, an increase in rates among males contrasted with a decline among females over the study period. Incidence and mortality rates of oral cavity cancer in South and South-East Asia are among the highest globally. Our results suggest an optimistic trend of reduction in oral cavity rates in the region, despite an increase in rates among Indian males.

Rise in arsenic pollution and oral cancer: A call for action

Over 140 million individuals across 70 countries have been exposed to arsenic with the levels surpassing World Health Organization guidelines. Epidemiological evidence strongly supports a causal relationship between oral cancer and arsenic, necessitating stringent regulatory policies and public health initiatives. This commentary delves into the carcinogenic qualities of arsenic, specifying its interference with vital biological functions and its role in promoting cancer development and progression. Regional disparities in oral cancer incidence are linked to varying levels of arsenic exposure, predominantly in areas with contaminated water sources. The challenges in prevention and advocates efficient screening, awareness campaigns, and long-term arsenic remediation are the need of the hour. Despite scientific controversies surrounding the linkage of arsenic with oral cancer, the overwhelming evidence demands coordinated action to combat arsenic contamination and its severe oral health consequences. We also discussed the therapeutic potential of arsenic in oral cancer. Future research is proposed to investigate the molecular role of arsenic in gutkha and tobacco users, considering its contribution to oral cancer heterogeneity.

Evaluation of Plant Essential Oils as Natural Alternatives for Alcohol-based Mouthwashes: Spotlight—Lemongrass and Citronella Java

Abstract Objective The purpose of our study was to evaluate plant-derived essential oils (EOs) as natural alternatives to commercial alcohol-based mouthwashes in the prevention of dental caries since several recent studies have linked high incidence of oral cancer among users with a history of prolonged use of alcohol-based mouthwashes. Materials and Methods Lemongrass, Citronella Java, Gingergrass, and Caraway seed EOs were tested against commonly occurring multidrug-resistant (MDR) oral bacteria namely Micrococcus luteus, Enterococcus faecalis, Streptococcus oralis, and Streptococcus salivarius. Agar well diffusion method was used to determine the antibacterial effectiveness of these EOs. Samples of Citronella Java and Lemongrass EO were also analyzed by gas chromatography (GC). Results Lemongrass and Citronella Java exhibited the highest antibacterial activity against all four bacterial strains. Inhibition zones of Lemongrass were 12, 21.3, 28.3, and 32 mm in diameter against E. faecalis, M. luteus, S. oralis, and S. salivarius, respectively. In comparison, inhibition zones of Citronella Java were 11.5, 17, 20.7, and 20.2 mm in diameter against E. faecalis, M. luteus, S. oralis, and S. salivarius, respectively. A significant finding in our study was that antibacterial activity of Lemongrass was much higher than that of tetracycline, a broad-spectrum antibiotic, against S. oralis and S. salivarius, while the inhibitory effects of Citronella Java against these two oral streptococci were comparable to tetracycline. The major components of Citronella Java identified by GC were citronellal, citronellol, and geraniol, whereas Lemongrass was primarily composed of cis and trans forms of citral. Conclusion Our results suggest that Lemongrass and Citronella Java could be promising natural alternatives to alcohol-based mouthwashes against MDR oral bacteria in the prevention of dental caries.

Malnutrition as a Risk Factor in the Development of Oral Cancer: A Systematic Literature Review and Meta-Analyses.

This systematic review and meta-analyses aimed to assess whether malnutrition may increase the incidence of oral cancer. Following the PRISMA statement, the research was conducted on PubMed, Scopus, and MEDLINE via OVID without any time restrictions. The risk of bias was assessed, and the quality of evidence for each performed meta-analysis was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Sixty-one articles met the inclusion criteria and seven studies underwent quantitative evaluation. For our meta-analysis on hypovitaminosis B, three studies with a total of 90,011 patients were included. An odds ratio of 2.22 was found. Our meta-analysis on the correlation between vitamin C and oral cancer included one study with a total of 866 patients and the derived odds ratio was 1.06. Our meta-analysis on the relationship between vitamin D deficiency and the incidence of oral cancer included three studies with a total of 12,087 patients and the odds ratio was -2.58. The GRADE system showed a moderate strength of evidence due to the presence of studies with a high risk of bias and high indirectness of the data given. The present findings suggest that an inadequate intake of vitamins, particularly vitamin D, poses a risk for the onset of oral cancer.

Epidemiological study on the association between tobacco chewing and cigarette smoking in head and neck cancer patients, India

Background: Tobacco consumption, including smoking and chewing, is a significant risk factor for head and neck cancer in India. This study aims to examine the correlation between tobacco use and the causation of cancer among oral cancer patients. Methods: We used the hospital-based cancer registry database at Savera cancer and multispeciality hospital in Patna. This is a retrospective analysis of head and neck cancer patients. The study was conducted from January 2019 to December 2022, involving patients aged 18-75 years. Histopathology Confirmed cases (n=691) of head and neck cancer were categorized into four groups: Only smoking tobacco (N=286), Only chewing tobacco (N=243), Smoking and chewing tobacco (N=139) and non-smoking and non-chewing (N=23), and examined. Results: Among the random cases examined (n=691), the distribution was as follows: only smoking tobacco - 286 (41.4.0%), only chewing tobacco 243 (35.2%), Smoking and Chewing Tobacco 139 (20.1%), and non-smoking and non-chewing tobacco 23 (3.3%). Statistical analysis revealed a significant (p&lt;0.005) association between tobacco consumption and oral cancer incidence. Conclusions: Long-term exposure to chewing/non-chewing tobacco appears to play an important role in the development of head and neck cancer. There is an urgent need for preventive measures, including targeted interventions and public health campaigns, to mitigate the burden of cancer associated with it.

Oral cavity cancer incidence and survival trends: A population-based study.

The present study aimed to calculate the burden of oral cavity cancer (OCC) including incidence, mortality rate, survival rate, and influence of predictive factors such as clinicopathological, demographic findings, and treatment modalities. Data in this retrospective study were collected from India's population-based cancer registry (PBCR) from 2010 to 2016. A total of 1051 cases of OCC were noted. Incidence and mortality rates were calculated. The cumulative survival outcome was calculated using Kaplan-Meier (KM) method. Prognostic factors were estimated using the Cox proportional hazard regression model. The age-standardized incidence rates (ASR), and mortality rate (ASMR), of overall OCC cases were 10.1 and 8.4 per 100 thousand population, respectively. Five-year overall survival (OS) was 32.3%. Survival outcome was significantly associated with the given treatment (Chi-square value = 58.17, P = 0.0001) and anatomical site (Chi-square value = 26.70, P = 0.0001). 17.6% of cases in males were <39-year age group. The hazard ratio (HR) in the age group of >50 years was 2.065 (95% CI 1.34-3.18, P = 0.001). Combination therapy had an HR of 2.630 (95% CI 1.91-3.63, P value 0.000). Tonsillar carcinoma (C09) (95% CI 1.04-3.12) had 1.8 times more chances of death than lip carcinoma (C00). OCC cases are increasing in the younger population, and overall, cases show higher mortality rates with reduced survival outcomes. Prognostic factors such as age >50 years, single modality treatment, and alveolar and tonsillar malignancy are associated with poor survival. OCC robust screening by a trained health professional can improve early detection and increases awareness and lower mortality of the disease.

RNA-based liposomes for oral cancer: From biophysical characterization to biological evaluation

Oral cancer incidence and mortality are increasing over time. The most common therapies for oral cancers are surgery and radiotherapy, either used alone or combined, and immunotherapy can be also an option. Although there are several therapeutic options, none of them are completely effective, and in addition, there are numerous associated side effects. To overcome these limitations, researchers have been trying to reduce these drawbacks by using drug delivery systems that carry drugs for specific delivery to cancer cells. For that purpose, RNA-coated liposomes to selectively deliver the ligands C8 (acridine orange derivative) and dexamethasone to oral cancer cells were produced, characterized, and biologically evaluated.Firstly, the RNA structure and binding interaction with ligands (C8 and dexamethasone) were evaluated by circular dichroism (CD), thermal difference spectroscopy (TDS), nuclear magnetic resonance (NMR) and fluorescence titrations. The biophysical assays evidenced the formation of an RNA hairpin and duplex structure. Moreover, steady-state and time-resolved fluorescence intensity and anisotropy experiments show that C8 forms a complex with RNA and adopts an open conformation upon RNA binding.Then, RNA-coated liposomes were characterized by dynamic light scattering, and diameters near 160 nm were observed. Time-resolved anisotropy measurements of C8 loaded in RNA-functionalized liposomes indicate the co-existence of free C8 in solution (inside the liposome) and C8 bound to RNA at the external liposome surface. The RNA-functionalized liposomes loaded with C8 or dexamethasone mediated a significant reduction in the cell viability of malignant UPCI-SCC-154 cells while maintaining viable non-malignant NHDF cells. Additionally, the liposomes were able to internalize the cells, with higher uptake by the malignant cell line.Overall, the results obtained in this work can contribute to the development of new drug delivery systems based on RNA-coated liposomes.

The Impact of Exposure to Hexavalent Chromium on the Incidence and Mortality of Oral and Gastrointestinal Cancers and Benign Diseases: A Systematic Review of Observational Studies, Reviews and Meta-Analyses

Background: Limited evidence suggests a possible connection between natural or occupational exposure to chromium and an increased risk of gastrointestinal cancer. The main objective of this study is to investigate the literature regarding chromium exposure and gastrointestinal health issues (i.e., cancer). Methods: A systematic literature search was performed using PubMed, Google Scholar and ScienceDirect. Included observational studies were assessed for their risk of bias. Results: 16 observational studies and 7 reviews and meta-analyses met the inclusion criteria. Most of the studies investigated gastric and hepatocellular cancer, followed by colorectal, oral, esophageal and pancreatic cancer. There is a limited amount of evidence regarding non-malignant gastrointestinal diseases. Chromium exposure is suspected to increase gastric and colorectal cancer risks. We did not find any convincing indications for increases in oral, esophageal and hepatocellular cancer. Pancreatic, gallbladder and extrahepatic bile ducts carcinogenesis is likely not associated with chromium exposure. Conclusion: We found weak evidence that chromium exposure is associated with gastric and colorectal cancer. Our review also highlights the existing controversial evidence regarding oral, esophageal and hepatocellular cancer, as well as the gap in studies investigating small intestinal cancer and non-malignant gastrointestinal health issues.

Leukoplakia and erythroplakia in youngers versus older individuals: a clinicopathological retrospective study.

The incidence of oral cancer has exhibited a rise within the young population. Considering that oral potentially malignant disorders (OPMDs) can precede the development of oral cancer, it is imperative to conduct studies in this particular younger population. This study aimed to evaluate the frequency and conduct a comparative analysis of the clinical-demographic characteristics of OPMDs in two distinct age groups. A retrospective analysis was conducted with patients diagnosed with leukoplakia, erythroplakia, and leukoerythroplakia between 1965 and 2020. The individuals were categorized into two groups: those aged up to 40 years (Group Younger) and those aged 41 years and above (Group Older). A total of 640 lesions were subjected to analysis. Among these, patients aged up to 40 years constituted 10.63% of the sample, however, this proportion decreased significantly to 6.9% between 2010 and 2020. A predominant male representation was observed in both groups, with white lesions being the most common in both as well. However, the frequency of red or mixed lesions was significantly higher (p=0.034) in the older group, along with a higher prevalence of dysplastic lesions (26.9% versus 11.8%, p=0.01). Moreover, the older group exhibited a relatively higher percentage of smokers/ex-smokers (78.6%), compared to the younger group (61.5%, p=0.085) and alcohol consumers/ex-consumers (54.9% versus 22.7%, p=0.028). Elderly individuals exhibited an unfavorable progression (p=0.028). However, a logistic regression analysis identified as significant variables associated with malignant transformation, the presence of epithelial dysplasia, and red lesions diagnosed as erythroplakia. A declining frequency of OPMDs in young adults was observed over the years, whereas in older adults, these disorders exhibited an unfavorable progression.

Exploring Oral Cancer Patterns: A 5-year Retrospective Analysis of Incidence, Clinical Features, Patient Behaviour and Treatment Outcomes at the Dental Unit of a Private Medical College and Hospital in Varanasi, Uttar Pradesh

Abstract Introduction: Oral cancer is a global health challenge. In India, there is a huge burden on the healthcare system. The prevalence of oral cancer globally and in India, coupled with the specific risk factors associated with the Indian population, necessitates targeted research to improve early detection and treatment outcomes. The present study analysed 93 patients with oral cancer over 5 years to determine the incidence corresponding to different stages of the disease. Materials and Methods: This retrospective cross-sectional study reviewed medical records from the hospital database. The epidemiological data included age, gender, tobacco habit, duration of tobacco use, site of the lesions, stages of cancer and the treatment provided. We analysed the relationship of epidemiological characteristics with age by the Chi-square test. The statistical test significance level was set at P &lt; 0.05. Results: The incidences of oral cancer each year range from 8% to 12%. A male patient over 40 years of age was most affected by oral cancer 42 (45.16%). The most affected sites were buccal mucosa 36 (38.70%) and alveolus 33 (35.48%) amongst patients over 40 years of age. The predominant stage for the majority of cancer cases was Stage IV, accounting for 49 cases (52.68%). Additionally, the largest lesions, exceeding 4 cm in size, were observed in 64 cases (68.81%), and these instances were predominantly found in patients aged 40 years or older. Chewing tobacco emerged as a significant contributing factor to cancer, affecting 41 cases (42.08%), particularly among those with a habit duration exceeding 10 years, representing 48 cases (51.61%) in patients aged 40 years or older. Conclusion: There is an urgent need to spread awareness of oral cancer, followed by extensive screening in India. Tobacco in India is not only used widely but also associated with cultural relevance, and it is the need of the hour to implement the tobacco policy to reach out evenly to all communities.

The impact of diabetes mellitus and the hypoglycemic agent metformin on oral health: A narrative clinical review

Diabetes mellitus (DM) is a common endocrine disorder that affects more than 10% of the adult population globally, 90% of which are type 2 DM (T2DM). DM was extrapolated to affect 20.5% of adult Jordanians by 2025, and around 50% of Jordanians attending dental clinics are at a moderate to high risk of developing T2DM in 10 years. The main morbidities of DM are angiopathy, nephropathy, retinopathy, and neuropathy rendering diabetic patients at a higher risk of myocardial infarctions, chronic kidney disease, blindness, and peripheral neuropathological impairment respectively. The common oral features associated with DM include gingivitis/periodontitis, dental caries, candidosis, xerostomia, sialosis, bacterial sialadenitis, burning mouth, halitosis, and dysgeusia. DM is also accused of being a risk factor for the development of oral/head and neck cancer, potentially malignant disorders and oral lichen planus. Metformin is the first-line treatment of T2DM with versatile use. In addition to its blood glucose-lowering effect, metformin has pleiotropic effects that may influence patients' oral health and dental management. Metformin therapy has a positive impact on oral health such as decreasing the risk of gingivitis/periodontitis, ameliorating the xerostomia, accelerating the healing of periapical pathology following endodontic treatment, increasing the success rate of the dental implant and lowering the incidence and mortality rate of oral cancer, in addition to its anti-microbial activity. On the other hand, metformin has a bitter taste, may cause taste alterations, decreases the orthodontic tooth movement rate, and can induce oral lichenoid reaction. For optimum dental and medical healthcare, providers should be fully aware of the oral manifestation associated with DM and metformin therapy.

Assessment of Awareness and Knowledge of Oral Potentially Malignant Disorders and Oral Cancer among Accredited Social Health Activist Workers from Randomly Selected Blocks of Thrissur District, Kerala, India: A Cross Sectional Study

Introduction: Oral and oropharyngeal cancers are prevalent in the head-and-neck region, with global rates decreasing. However, in India, they are rising due to a lack of knowledge about risk factors and symptoms. The Indian government launched the National Health Mission to provide accessible, affordable, and reliable primary health care. Accredited social health activist (ASHA) workers can link health services to rural people. This study aimed to evaluate the awareness level among these workers about potentially malignant oral disorders and oral cancer (OC). Materials and Methods: A predesigned semi-structured questionnaire-based descriptive cross-sectional study was conducted among 150 voluntary ASHA workers from randomly selected blocks of Thrissur district, Kerala, to collect the data. Results: Our study showed that the majority of ASHA workers (82.3%) were aware of the role of tobacco in OC. A substantial portion of workers (88.4%) expressed that early detection of OC is possible at its initial stage. Less than 10% (7.5%) of all the ASHA workers were educated by dentists, whereas almost three-quarters (75.5%) of ASHAs preferred primary health center health practitioners as primary representatives for early OC detection, despite their being poorly trained in the early diagnosis and detection of OC. Conclusion: India has made progress in controlling malignancies but still lags in reducing OC mortality rates. Spreading knowledge of contributory agents and early detection methods through ASHA workers could reduce the incidence and mortality of OC. Including more dentists in the public health system and training ASHA workers on early OC detection can play a major role in reducing its incidence.

A study to evaluate the role of antioxidants and iron as diagnostic markers in oral cancer

Oral cavity (OC) and oropharyngeal (OP) cancers afflict about 500,000 people globally. Dental health care practitioners need to understand the causes, diagnosis, and treatment of oral cavities and oropharyngeal cancer. The constant and direct exposure of oral mucosal cells to tobacco product chemical carcinogens such as polynuclear aromatic hydrocarbons and nitrosamines causes the generation of free radicals/reactive oxygen species. Changes in salivary antioxidant and micronutrient levels may prove to be an important factor in the pathogenesis of oral premalignant and malignant disorders. The present study aimed to evaluate the levels of Vitamin C, MDA and iron levels in oral cancer, pre-malignant group and the oral cancer group. 15 oral cancer patients, 30 premalignant condition patients, and 15 normal controls were analyzed in the study. Among the 30 patients of the premalignant conditions- group (Group S1) 12 were diagnosed with oral submucous fibrosis, and 18 of them were diagnosed with oral leukoplakia. The oral cancer patients (Group S2) were segregated based on the TNM system from stages I to IV. The oral submucous fibrosis patients were subdivided into four grades. The oral leukoplakia patients were categorized into homogenous and speckled types. A detailed history was obtained from the patients. After obtaining informed consent, saliva samples will be collected from patients who have not consumed any food or any form of tobacco 2 hours before collection. Following a thorough mouth rinse using distilled water, saliva is allowed to accumulate in his or her mouth for 5 minutes. Accumulated saliva is collected by the spit method. 5ml of blood sample will also be collected from these patients, Serum was separated by Centrifugation. Collected serum and saliva were stored at -80℃ until further analysis. The serum and salivary samples were then analyzed for Vitamin C, iron, and malonaldehyde (lipid peroxidation) according to the standardized protocol. In the present study, a total of 60 samples were screened for Vitamin C, Iron, and MDA in both serum and saliva of normal control, premalignant, and oral cancer patients. We found that there was a decreased level of Vitamin C and iron in both serum and saliva of premalignant and oral cancer patients. MDA level was higher in premalignant, and oral cancer patients and there was a significant increase in the level of MDA in oral cancer patients. Understanding antioxidants can help reduce the incidence of oral cancer in its early stages. More study is needed before this supplement may be recommended as an adjuvant treatment.