Risk Factors For Oral Cancer Research Articles

Analysis of Epstein-Barr Virus Infection in Oral Potentially Malignant Disorders and Oral Cancer: A Cross-Sectional Study.

The primary objective of this study is to determine the prevalence of Epstein-Barr virus (EBV) in oral potentially malignant disorders (OPMDs) and oral cancer (OC) in a group of Thais using polymerase chain reaction (PCR) and Epstein-Barr encoding regions (EBERs) in situ hybridization (ISH). The secondary objective is to investigate the risk factors of OC and the association between the presence of EBV and risk factors of OC/site of oral lesions. Sixty-one participants attending the screening project for OC and OPMDs at the Northeastern district hospitals of Thailand were recruited. Information related to risk factors and biopsy tissues for histopathological diagnosis was collected. Sixty-seven paraffin tissue blocks, including 52 OPMDs and 15 OC specimens, were investigated for EBV infection, using PCR analysis with latent membrane protein-1 (LMP-1) primer and EBERs ISH. Pearson's Chi-square or Fisher's exact test was used to analyze the differences in variables between participants with OPMDs and OC, as appropriate. The association between EBV infection and related risk factors was analyzed using logistic regression with a significant level at 0.05. Using PCR analysis, 8 of 67 specimens (11.94%) were positive for LMP-1. Three cases of OPMDs were positive for both LMP-1 PCR and EBERs ISH. Regarding risk factors of OC, the two most common risk factors were betel nut chewing (52.46%) and working in sunlight (42.62%). The habit of taking alcohol was significantly different between the OC and the OPMDs groups (p = 0.009). The association between LMP-1 and the lesion at the tongue was statistically significant, with odds ratio = 4.900 (95% confidence interval = 1.046-22.943; p = 0.044). The prevalence of EBV infection in this group of participants was low. However, OPMDs at the tongue exhibited a significant association with EBV infection.

Demographic profile and risk factors of head-and-neck squamous cell carcinoma in west Tamil Nadu: A cross-sectional observational study

ABSTRACT JOURNAL/crsat/04.03/02201859-202306020-00007/figure1/v/2023-08-03T140821Z/r/image-tiff JOURNAL/crsat/04.03/02201859-202306020-00007/figure2/v/2023-08-03T140821Z/r/image-tiff Background: Head-and-neck squamous cell carcinomas (HNSCC) comprise 30% of all cancer cases in India. The risk factors for HNSCC include tobacco and alcohol consumption. Objectives: Our primary objective was to evaluate the epidemiological profile of patients with HNSCC in the western Tamil Nadu population. Our secondary objective was to assess the association of the epidemiological profile with different anatomical sites and risk factors. Materials and Methods: This was a cross-sectional study of data compiled from the clinical records of Sri Ramakrishna Institute of Oncology and Research Department, Sri Ramakrishna Hospital, Coimbatore (Tamil Nadu, India) from January 2018 to December 2021. Clinicodemographic data like age, sex, primary tumor site, clinical staging, family history, and exposure to risk factors (smoking, tobacco chewing, alcohol) were collected from patients with histologically confirmed HNSCC using a specially designed questionnaire. Human papillomavirus (HPV) status was determined by p16 immunohistochemistry and validated using polymerase chain reaction (PCR) by employing consensus primers for HPV deoxyribonucleic acid (DNA). Results: We enrolled 150 patients. The male-to-female ratio was 3:1. The mean age was 54.4 ± 10.2 years; majority of patients (59 [39.3%]) were aged between 51 and 60 years. The most frequently affected site was the oral cavity (58 [38.7%]). Tobacco chewing was the most common and the only risk factor observed among female patients (23 [62.2%]), while smoking along with alcohol consumption was commonly observed among male patients (24 [21.2%]). Smoking in combination with other risk factors (44 [29.3%]) was more common than smoking alone (9 [8%]). Tobacco chewing was a predominant risk factor for nasopharyngeal (4 [63.6%]) and oral cavity cancer (19 [32.8%]), while smoking was a predominant risk factor for laryngeal cancer (3 [30%]). Smoking with alcohol consumption was largely seen in oropharyngeal cancer (5 [33.3%]), while all three risk factors were observed in hypopharyngeal cancer (4 [14.3%]). Out of 38 samples tested, only four were positive for HPV (10.5%). Conclusions: The most affected demographic group with regard to HNSCC is middle-aged men (51–60 years), and the oral cavity is the most commonly affected site. Tobacco chewing is the most prevalent risk factor among women while smoking and alcohol consumption are the most common risk factors among men. Spreading awareness about the risk factors of HNSCC and their prevention is crucial to optimizing disease control.

Histopathological and risk factor analyses of oral potentially malignant disorders and oral cancer in a proactive screening in northeastern Thailand

BackgroundLip and oral cavity cancer has been reported as the 10th most common cancer in Thailand. Recently, a screening program for oral potentially malignant disorders (OPMDs) and oral cancer was conducted in the northeastern Thailand which took into consideration a total of 371,911 people who resided in the provinces of Buriram, Chaiyaphum, Nakhon Ratchasima, and Surin.MethodsA total of 330,914 subjects were consecutively screened for risk factors of oral cancer by village health volunteers (VHVs) using a questionnaire (S1). Then, 186,710 subjects with one or more risk factors for oral cancer were referred for oral screening by dental auxiliaries or dentists at sub-district level hospitals (S2) where 86,941 subjects were subsequently screened. Afterwards, 1576 subjects with suspicious oral lesions for OPMDs or oral cancer attended local hospitals for further investigation and treatment. Oral medicine specialists, oral surgeons, and local dentists at the district level hospitals performed biopsies and the samples were sent for histopathological analysis. The objectives of the study were to report the histopathology findings from the biopsies obtained from these subjects and the associated risk factors.ResultsOut of 427 subjects who received biopsies, complete diagnostic results were obtained from 409 patients (462 specimens). The 5 most common histopathological results from these specimens were mild epithelial dysplasia (27.3%), fibroepithelial hyperplasia (14.5%), oral lichen planus/oral lichenoid reactions (11.5%), moderate epithelial dysplasia (8%), and acanthosis with or without hyperkeratosis (5%). Oral squamous cell carcinoma was detected in 14 subjects and 11 other forms of oral cancer were revealed. Among the analyzed risk factors, habitual betel quid chewing was established as a statistically significant risk factor associated with OPMDs and oral cancer.ConclusionThe most frequently observed histopathological results of clinically suspected oral cancer and OPMDs included mild epithelial dysplasia, fibroepithelial hyperplasia, oral lichen planus/oral lichenoid reactions, moderate epithelial dysplasia, and acanthosis with or without hyperkeratosis. Betel quid chewing habit was found to be associated with OPMDs and oral cancer.

Changing trend of oral cancer disease burden in China from 1990 to 2019 and the forecast for the next 20 years.

This study aimed to explore the trend of oral cancer (OC) disease burden in China from 1990 to 2019 and predict the disease burden in the next 20 years. OC data collected for 15 years old in China from 1990 to 2019 were obtained from the 2019 Global Burden of Disease Study. Estimated annual percentage changes (EAPCs), with respective 95% CI, were used to assess incidence, mortality, disability-adjusted life-year (DALY), and their trends. From 1990 to 2019, the age-standardized rate of incidence, mortality, and DALY of OC in China showed an upward trend with EAPCs of 2.33 (95% CI=2.01-2.63), 1.44 (95% CI=1.15-1.73), and 1.24 (95% CI=0.95-1.52), respectively. The main risk factors for OC in China were smoking and alcohol consumption. New cases, deaths, and DALYs due to OC are predicted to increase >1.5 times over the next 20 years. The number of cases, deaths, and DALYs will continue to increase in the next 20 years. Therefore, the control of risk factors, such as tobacco and alcohol consumption, needs to be strengthened to reduce the burden of OC in China.

Development and professional validation of an App to support Oral Cancer Screening

Simulated clinical cases were designed so that 40 professionals with expertise in oral diagnostics could validate the algorithm and test its usability (SUS: System Usability Score) and acceptability (TAM: Technology Acceptance Model). Cronbach's alpha coefficient, Friedman/Dunn tests, and Spearman correlation evaluated the SUS and TAM scales. ROC curve was plotted to estimate the cutoff point of the algorithm in suggesting a high risk for OCS of the simulated cases. Chi-square and Fisher's exact tests were additionally used (p<0.05, SPSS v20.0). Professionals with expertise in oral diagnosis had usability of 84.63±10.66 and acceptability of 84.75±10.62, which correlated positively (p<0.001, r=0.647). Acting in clinical areas of dentistry (p=0.034) and history of performing OC risk factor orientation (p=0.048) increased acceptability while acting in higher education increased usability (p=0.011). The cutoff point suggested by the App after validation of the simulated clinical cases showed high sensitivity of 84.8% and lower specificity of 58.4%. The OCS was effective and with adequate sensitivity, usability, and acceptability and may contribute to the detection of early oral lesions.

Review of liquor consumers' malpractice concerning oral care

Alcohol being used on a daily basis is an established social norm globally. Heavy alcohol use, particularly when combined with smoking, is a significant oral cancer risk factor. Alcohol addiction is a common concern in all communities. Alcohol drinking can lead to a variety of problems, including oral health issues such as periodontal disease, plaque build-up, and caries in individuals of all ages and sexes. Alcoholics and drug abusers frequently overlook their oral health; in this circumstance, dental health care professionals play a vital role in promoting oral health and further providing prevention of other oral and systemic illnesses.

Time intervals and patient-level factors in oral cancer diagnostic pathways: An application of the WHO framework in India

BackgroundOral cancer, a leading cancer-site in India, is often detected at advanced stages. We evaluated the time intervals from first symptom to help-seeking and diagnosis among oral cancer patients. MethodologyIn this cross-sectional study, we recruited 226 consecutive oral cancer patients (mean age ( ± SD) 51.9 years ( ± 10.9); 81.9% men; 70.3% advanced stage) registered for diagnosis and treatment, between 2019 and 2021 at a cancer care centre in South India. We used WHO framework and previously standardized tools to record time intervals (appraisal, help-seeking and diagnostic) and baseline characteristics. We utilized multivariable logistic regression models to test the associations between ‘prolonged (i.e., over 1 month) time intervals’) and patient-level factors to estimate odds ratios (ORs) with 95% confidence intervals (CIs). ResultsOver a half of patients presented with prolonged appraisal (60%) and help-seeking intervals (57%), and a third (34%) reported prolonged diagnostic interval. Patients with no formal education, no routine healthcare visits, no self-reported risk factors, and those who did not perceive initial symptoms to be serious were 2–4 times more likely to have prolonged appraisal and help-seeking than the rest. High travel costs and self-decision for visiting healthcare facility prolonged help-seeking. Diagnostic interval was prolonged only among women OR= 2.7 (95% CI: 1.2–6.1)) and in patients whose first doctor’s opinion was ‘nothing to worry’ OR (=7.3 (95% CI: 2.6–20.5)). ‘Correct knowledge of cancer’ shortened appraisal and help-seeking intervals and ‘incorrect knowledge and negative beliefs’ prolonged diagnostic interval. ConclusionOur findings highlight that interventions targeting sociocultural and economic determinants, symptom awareness, sensitizing persons at risk (especially women) and primary care providers might reduce overall time to diagnosis. Further, patients without any known risk factors for oral cancer might be at-risk for prolonged appraisal interval. These might help inform ‘pull’ strategies for cancer control in India and similar settings.

Perception of the risk factors for oral cancer and access to preventive actions in the perspective of the population in street situation and health professionals Rio Branco, Acre, Brazil.

Backgroung: in Brazil, the homeless population is a phenomenon that involves a variety of factors that, among the most frequent, are: the rupture of family bonds, the inexistence of work and the absence or insufficiency of income and frequent use of alcohol and other drugs. Objective: to analyze the perception of oral cancer, its risk factors and preventive actions from the perspective of the homeless population and health professionals from the team Clinic on the Street in the city of Rio Branco, Acre, Brazil. Methods: a qualitative study, developed through Content Analysis, carried out from January to April 2018, with the homeless population and health professionals’ team of Clinic on the Street in Rio Branco, Acre, Brazil. Results: it was evidenced that the homeless population’ situation and the health professionals of Clinic on the Street have perception about the risk factors related to this aggravation, however the users are not concerned with preventive actions. The professionals of the team do not develop actions aimed at the prevention of the disease. From the perspective of the team and the users, preventive actions can be developed, however what is predominant is the accomplishment of punctual actions with emphasis on changing harmful habits. Conclusion: the homeless population and the professionals from Clinic on the Street are aware of the main risk factors for oral cancer. The team does not develop specific actions to prevent this disease and users understand the need for prevention. The difficulty of access and the period of return to the dental surgeon are factors that make prevention difficult.

Trends in the global burden of oral cancer joint with attributable risk factors: Results from the global burden of disease study 2019

ObjectivesTo investigate the characteristics of risk factors for oral cancer and the disease burden they caused. Materials and methodsData from GBD2019, where the EAPC was calculated to understand mortality trends and the APC model was used for the analysis of age characteristics. ResultsOverall oral cancer mortality showed a promising downward trend [EAPC = −0.05 (−0.08 to −0.02)]. Oral cancer mortality attributable to tobacco chewing alone showed a significant upward trend [EAPC = 0.44 (0.36–0.52)]. Males are the majority of oral cancer deaths, while the disease burden of oral cancer in females could be largely attributable to chewing tobacco. The age of death attributable to each risk factor for oral cancer is concentrated between 45 and 74 years. Mortality for oral cancer caused by alcohol and smokeless tobacco was increasing in younger age groups (age < 45), and this trend was more pronounced in middle and middle-high SDI areas. The disease burden of oral cancer in high SDI regions was mainly attributed to alcohol consumption, while in middle and lower SDI regions it was mainly attributed to tobacco. ConclusionSmokeless tobacco proved a critical factor in the significant regional distribution of oral cancer. Oral cancer is on the increase in younger age groups. According to the characteristics of the distribution of risk factors, in traditionally high-incidence regions, such as India and Pakistan, oral cancer kept the highest ASDR, but was not experiencing the fastest growth rate. Additionally, it was oral cancer in middle SDI regions that needs more attention.

THE RELATIONSHIP BETWEEN THE USE OF SMOKELESS TOBACCO AND ORAL SQUAMOUS CELL CARCINOMA

Smokeless tobacco (ST) is a tobacco product that is used by means other than smoking. Evidence was available that ST products is a known risk factor for oral precancerous and cancers for long, with greater risk for oral cancer than others. The prospective, descriptive study has carried out to evaluate the relationship between the use of smokeless tobacco and oral cancer.Biopsy samples have collected from 60 patients, whose have attended to Al-Gamhouria Teaching Hospital and histo-pathological private labs in Aden using a questionnaire during the period of 12 months. The sections from paraffin-embedded tissue specimens were stained with hematoxylin and eosin (H &amp; E). A section containing the full thickness of the tumors have used for histopathological grading.The prevalence of oral squamous cell carcinoma (OSCC) lesions showed different grade of differentiation among 60 studied patients cases, the Well differentiation squamous cell carcinoma (WDSCC) was the highest percentage (70%). No significant difference noticed in well-differentiated SCCs (WDSCC) between men (36.7%) and women (33.3 %; P &lt; 0.05). The moderate differentiation SCC (MDSCC), and the poor differentiation SCC (PDSCC) represented (20% &amp; 10%) respectively. According to the age of patients, WDSCC, MDSCC and PDSCC highest percentage age group was (51-60) years. Male were predominant in both genders, male to female ratio 1.2: 1. Anatomical sites of all OSCC lesions had analyzed and revealed that tongue was the most prevalent site (33.3%), followed by the buccal mucosa, (23.3%) , floor of mouth (16.7%) , lip (13.3%), Gingiva (8.3%), and the least prevalent site was the hard palate represented (5%) of all cases., the chief etiological factor which we observed, was tobacco, in the form of smoking tobacco used by 75% of the patients followed by smokeless tobacco product users, in form of shamma chewers, (61.7%), and in form of Hot sachet (58.3%), and Zarda users represented 51.7% of cases.Our results indicate that the occurrence of OSCC among studied cases showed different grade of differentiation, age and gender have some relation with the presence of OSCC. and it is high association with risk habits of tobacco use in different forms particularly smokeless tobacco.

Analysis of Risk Factors of Oral Cancer and Periodontitis from a Sex- and Gender-Related Perspective: Gender Dentistry

Gender-specific medicine studies how sexual biology and gender-related cultural and behavioral differences may influence a person’s health and considers the differences in clinical features, prevention, therapies, prognosis, and psycho-social aspects of diseases with different impacts on women and men. The present work summarizes the main differential impact each risk factor for oral cancer and periodontitis has according to biological sex- and gender-oriented differences. It resulted in differences in epidemiology and the weight of various healthy determinants that may influence the incidence and prognosis of oral cancer and periodontitis. It is desirable to change the methodology of scientific studies with a higher focus on the weight that sexual variables may have on the well-being or the probability of getting ill of each person, thus promoting the development and diffusion of personalized gender dentistry.

Association between oral cavity cancer and metabolic syndrome.

Few studies have been conducted on the association between oral cavity cancer and metabolic diseases. This study aimed to investigate the relationship between oral cavity cancer and metabolic diseases. This cohort study used the database of the Korean National Health Insurance Service, which contains medical data of 97% of the Korean population. Oral cavity cancer occurred in a total of 2718 patients. Metabolic syndrome was defined according to IDF criteria. The Cox proportional hazard regression model was used. The HR for oral cavity cancer in patients with metabolic syndrome was 1.113(95% CI 1.006-1.232), which was significantly higher than that in normal patients, especially in males (p = 0.0386). When the number of metabolic syndrome factors was ≥ 3, the HR of oral cavity cancer was 1.191(95% CI 1.026-1.383), which was significantly higher than that of 0 metabolic syndrome factors, especially in males (p = 0.0218). When the number of metabolic syndrome factors was ≥ 3, the HR for oral cavity cancer was 1.439(95% CI 1.066-1.942), which was significantly higher than that of 0 metabolic syndrome factors, especially in males aged < 50years (p = 0.0173). Metabolic syndrome increases the risk of oral cavity cancer only in males. In addition, the incidence of oral cavity cancer increased as the number of factors constituting metabolic syndrome increased, only in young males aged < 50years. Thus, metabolic syndrome is an important risk factor for oral cavity cancer, particularly in young males.

Commonalities in Metabolic Reprogramming between Tobacco Use and Oral Cancer.

Tobacco use is a major public health concern and is linked to myriad diseases, including cancer. The link between tobacco use and oral cancer, specifically, is very strong, making tobacco use one of the primary risk factors for oral cancer. While this association is well known, the underlying biochemical changes that result from tobacco use, and how this links to metabolic phenotypes of oral cancer, is not well understood. To address this knowledge gap, a combination of literature reviews and metabolomics studies were performed to identify commonalities in metabolic perturbations between tobacco use and oral cancers. Metabolomics analysis was performed on pooled reference urine from smokers and non-smokers, healthy and malignant oral tissues, and cultured oral cells with or without treatment of the well-known tobacco carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). Alterations in amino acid metabolism, carbohydrates/oxidative phosphorylation, fatty acid oxidation, nucleotide metabolism, steroid metabolism, and vitamin metabolism were found to be shared between tobacco use and oral cancer. These results support the conclusion that tobacco use metabolically reprograms oral cells to support malignant transformation through these pathways. These metabolic reprogramming events may be potential targets to prevent or treat oral cancers that arise from tobacco use.

AWARENESS AND KNOWLEDGE OF TOBACCO ASSOCIATED RISK OF ORAL CANCER AMONG DENTAL PATIENTS: A SURVEY BASED QUESTIONNAIRE STUDY

Background: India ranks second in the world in tobacco production and of great import from the public health perspective, ranks third in tobacco consumption. It is estimated that the current global pattern of tobacco use will lead to the premature deaths of 250 million children and adolescents, most of them in developing countries. Therefore the aim of the present study was to assess the levels of awareness, knowledge about signs and risk factors of oral cancer. Methods: This hospital based cross sectional study was done to assess the awareness and knowledge of oral cancer in a population attending the dental out patient department of Index institute of dental sciences Indore. All the patients of the age of 18 years and above who was willing to participate were included in the study. Results: A total 300 questionnaires were analyzed, out of which male were 198 and female were 102 . Among them 93 patients were indulged in the habits of smoking and 176 of them were chewing smokeless form of tobacco. The habit of both smoking and smokeless tobacco was seen in 31 patients. When assessed for the prevalence according to the gender males were indulged predominantly in smoking than female. More than half of the subjects 178 were aware of related risk of development of oral cancer when compared gender wise male were more aware of harmful effect of oral cancer than females. Conclusion: This study concluded that the dental patients still had a lack of awareness regarding the risk of oral cancer, early signs and symptoms and the benefits of detecting this disease at an early stage.

Disparities in Oral Cancer Stage at Presentation in a High HIV Prevalence Setting In Sub-Saharan Africa.

Oral cancer is the sixth most common cancer worldwide and is the seventh most common in Botswana. Lack of improvement in oral cancer survival despite the availability of multiple treatment options may be due to the high prevalence of advanced stage at presentation. We identified risk factors for presenting with oral cancer at an advanced stage to facilitate interventions to reduce mortality from oral cancers. A retrospective cohort analysis was conducted among individuals with biopsy-confirmed oral cancer at Princess Marina Hospital in Gaborone, Botswana, between 2010 and 2020. Data collected included age at diagnosis, sex, place of residence, HIV status, oral cancer stage, and oral subsite. Multivariable analyses were controlled for age, sex, district of residence, and oral subsite. Of the 218 records analyzed, 79% were male, 58% were HIV-positive, the median age was 56 years (interquartile range: 47-63), and 67% presented with advanced-stage disease. Cancers from hidden oral sites were more likely to present at an advanced stage with an adjusted odds ratio (OR) of 2.98 (95% CI, 1.29 to 6.89; P = .01). Residence in socioeconomically disadvantaged districts was associated with higher likelihood (OR, 2.36; 95% CI, 1.28 to 4.39; P = .01) of advanced stage presentation compared with other districts. HIV infection was not associated with risk of advanced lesion presentation (OR, 1; 95% CI, 0.61 to 1.61; P = .97). Hidden oral cancer sites and residence in districts with limited access to care were risk factors for advanced oral cancer at the time of diagnosis in Botswana. These findings support a need to increase efforts to improve access to care and increase oral cancer awareness to decrease the burden of advanced oral cancer.

Evaluation of Salivary Lipid Peroxidation in Paan Users

Background: One known risk factor for oral cancer is chewing smokeless tobacco, which is common in southeastern Iran. Smokeless tobacco-related oral complications can be evaluated by assessing parameters of oxidative stress. Objectives: This study evaluated salivary malondialdehyde (MDA) levels in paan users and compared them with nonusers. Patients and Methods: In this study, saliva was collected from 50 paan users and 50 nonusers referred to the Zahedan Dental School in Zahedan, Iran. Salivary MDA was assessed based on standard biochemical methods, and the data were analyzed using t-test, chi-squared tests and analysis of variance. Results: In the paan users and the controls, the mean MDA was 2.19 ± 1.05 and 1.24 ± 0.62 (nmol/mL), respectively, and both groups showed significant differences (P &lt; 0.001). The daily consumption and duration were significantly related with the MDA concentration (P &lt; 0.001). Conclusions: In paan users, salivary MDA concentrations were higher. The concentration of salivary MDA increased with the consumption of paan in more quantities and for a more extended time.

Arecoline promotes proliferation and migration of human HepG2 cells through activation of the PI3K/AKT/mTOR pathway

BackgroundArecoline is a well-known risk factor for oral submucosal fibrosis and cancer. However, the mechanistic correlation between arecoline and hepatocellular cancer remains elusive. Here, we investigated the effect of arecoline on the proliferation and migration of human HepG2 hepatoma cells and its potential oncogenic mechanisms.MethodsBioinformatic technologies were used to identify the deferentially expressed miRNAs (DE-miRNAs) and hub target genes of arecoline-induced cancers. These DE-miRNAs, hub genes and pathway were proved in arecoline-treated HepG2 cells.ResultsA total of 86 DE-miRNAs and 460 target genes were identified. These target genes are associated with DNA-templated regulation of transcription and other biological processes. Significant molecular functions were protein binding, calcium ion binding, and enrichment in the nucleus and cytoplasm. These genes are involved in the PI3K-AKT pathway. CDK1, CCND1, RAF1, CDKN1B and BTRC were defined as the top 5 hub target genes, and patients with high expression of CDK1 showed poor prognosis. Compared with control group, 2.5 µM arecoline treatment increased the proliferation and migration ability of the HepG2 cells. Treatment with 2.5 µM arecoline increased the levels of miR-21-3p, miR-21-5p and miR-1267, upregulated the expression of PI3K-AKT pathway factors, CDK1, CCND1 but decreased RAF1 expression.ConclusionA low concentration arecoline can induce the proliferation and migration of HepG2 cells, with the potential mechanism of action linked to high levels of exosomal miR-21 and miR-1267, activation of the PI3K-AKT pathway, upregulation of CDK1 and CCND1, and downregulation of RAF1.

PERCEPTIONS REGARDING ORAL CANCER AMONG MEDICAL AND NURSING GRADUATES: A CROSS SECTIONAL STUDY IN A MEDICAL COLLEGE IN SOUTH KARNATAKA

ntroduction: Oral cancer ranks sixth among all types of cancer. India has the largest number of oral cancer cases and one-third of the total burden of globally.Though early detection of oral cancer provide long term survival and affordable healthcare, it still poses a signicant public health problem in India due to diagnosis in advanced stages, lack of accesibility to trained healthcare professionals and economical constraints for advanced facilities This cross sectional, lack of accesibility based study was conducted at Mandya Institute of MedicalMaterials and Methods: Sciences, Mandya to assess the perceptions regarding oral cancer among 100 MBBS and 100Nursing graduates from South Karnataka. A structured proforma was used to interview the participants which included (a) General information (b) Problem statement (c) Risk factors (d) Signs &amp; Symptoms (e) Diagnosis, and (f) Treatment &amp; prevention. Data was entered in MS excel spreadsheet. Descriptive analysis like proportion, mean, standard deviation, etc. was used. Statistical tests to detect signicant difference or association like T test, chi square test, etc was used. Results: The mean age of medical graduates was 25.9 ± 0.7 years and the mean age of nursing graduates was 23.1 ± 0.8 years. In this study 61.0% of the medical graduates were males whereas 86.0% of nursing graduates were female. The knowledge regarding the disease burden among medical graduates was 41.0% and that among nursing graduates was 23.0%. 86% of MBBS graduates and 84% of nursing graduates perceived smoking, chewing tobacco and tobacco with alcohol as risk factors for oral cancer. Most of the medical graduates (82.5%) and nursing graduates (87.5%) perceived white patch and weight loss as clinical features of oral cancer.Clinical examination as an aid to diagnose oral cancer was upheld by 89.0% of medical and 95.0% of nursing graduates. 95.0% of medical graduates knew that early stages could be treated with surgery and chemo- radiotherapy was preferred for advanced stage of the disease compared to 42.0% nursing graduates.

Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data.

This study compared prevalence, incidence, mortality rates, treatment costs, and risk factors for oral and oropharyngeal cancer (OC/OPC) between two large United States adult cohorts in 2012-2019. Medicaid and commercial claims data came from the IBM Watson Health MarketScan Database. Logistic regression analyses estimated incidence and risk factors for OC/OPC. Mortality was calculated by merging deceased individuals' files with those of the existing cancer cohort. Summing costs of outpatient and inpatient services determined costs. Prevalence of OC/OPC in Medicaid enrollees decreased each year (129.8 cases per 100,000 enrollees in 2012 to 88.5 in 2019); commercial enrollees showed a lower, more stable prevalence (64.7 per 100,000 in 2012 and 2019). Incidence trended downward in both cohorts, with higher incidence in the Medicaid (51.4-37.6 cases per 100,000) than the commercial cohort (31.9-31.0 per 100,000). Mortality rates decreased for Medicaid enrollees during 2012-2014 but increased in the commercial cohort. OC/OPC treatment costs were higher for commercial enrollees by $8.6 million during 2016-2019. OC/OPC incidence was higher among adults who were older, male, and white; used tobacco or alcohol; or had prior human immunodeficiency virus/acquired immune deficiency syndrome diagnosis and lower among those who had seen a dentist the prior year. Medicaid enrollees experienced higher OC/OPC incidence, prevalence, and mortality compared with commercially insured adults. Having seen a dentist within the prior year was associated with a lower risk of OC/OPC diagnosis. Expanding Medicaid dental benefits may allow OC/OPC to be diagnosed at earlier stages through regular dental visits.

Abstract LB160: Oral cancer incidence among smokers and smokeless tobacco users compared to nonusers of tobacco products - contemporary analysis of cancer registry data

Abstract Tobacco use has been identified as a risk factor for oral cancer (oral cavity and pharynx). However, the differential oral cancer risk among users of cigarettes and smokeless tobacco (ST) products has not been well studied. In this study, we estimate oral cancer incidence among adult males who were current smokers that had never used ST products (SM), ST users who had never smoked (STU), and nonusers of cigarettes or ST products (NON) using data from state-wide cancer registries and national surveys. Oral cancer incidence rates were estimated using Colorado, Florida, North Carolina, and Texas cancer registries from the years 2014 through 2017 (the most recent 4 years of available data). State-specific population counts by tobacco use status were estimated from the Tobacco Use Supplement to the Current Population Survey. Missing values in tobacco use status in cancer registry data were imputed either by assuming missing at random (MR) or using multiple imputation (MI). Poisson regression was used to estimate incidence rate ratios (IRR) by state and age group. A random-effect meta-analysis approach was used to summarize estimates by state and age groups while considering potential heterogeneity using the Mantel-Haenszel model. Cases of oral cancer among adult males 35 years and older with tobacco use data numbered 19,536 in the geographies studied over the covered period. Assuming MR, the pooled oral cancer IRR relative to NON were 1.0 (95% CI = 0.7 to 1.3) for STU and 3.4 (95% CI = 3.0 to 3.9) for SM, resulting in an IRR of 3.5 (95% CI = 2.5 to 4.9) for SM relative to STU. The corresponding MI-based estimates relative to NON were 1.4 (95% CI = 1.1 to 1.9) for STU and 3.6 (95% CI = 3.2 to 4.1) for SM, resulting in an IRR of 2.6 (95% CI = 2.0 to 3.3) comparing SM relative to STU. These estimates should be considered in the context of certain limitations, such as the estimates were not adjusted for other potential confounding variables (e.g., alcohol intake and other lifestyle factors, duration of tobacco use, and other tobacco product use) due to the lack of such information in data sources. Our population estimates based on state cancer registry data demonstrate that current ST users had a substantially lower oral cancer risk than current smokers. While causal relationships cannot be concluded, the large sample size in this contemporary analysis suggests that oral cancer risks among smokers may be reduced by switching to ST products; however, quitting all tobacco use is the optimal path for reducing oral cancer risks. Citation Format: Brendan Noggle, Hui Cheng, Mohamadi Sarkar. Oral cancer incidence among smokers and smokeless tobacco users compared to nonusers of tobacco products - contemporary analysis of cancer registry data [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB160.