Socio-demographic factors related to oral cancer.

Author:Madani, Abdoul Hossain
 
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INTRODUCTION

Cancers of the oral cavity includes cancers which occur in the tongue, floor of the mouth, Buccal mucosa, alveolus, retro molar trig one, gingival, hard palate and lips. It is one of the major worldwide public health problems (Franceschi et al., 2000) with the incidence and mortality rising in several regions of the world, including Europe, South Central Asia (particularly Taiwan) and Australia (Parkin et al., 2005). The prevalence of diagnosed oral cancer worldwide around 40% occur in India, Pakistan, Bangladesh and Sri Lanka (Ahluwalia, 2005). India has one of the highest rates in the world, accounting for one-third of the total cancers and unfortunately this form continues to rise (Pal and Mittal, 2004).

Tobacco and alcohol are established etiologic agents of these cancers, according to Castellsague et al. (2004) with attribute fractions of approximately 90%. Micronutrient deficiencies (Garrote et al., 2001; Sanchez et al., 2003) and poor oral hygiene (Talamini et al., 2000; Lissowska et al., 2003) has also been associated with increased risk. Oral cancer most commonly occurs in middle-aged and older individuals, although a disturbing number of these malignancies are also being documented in younger adults in recent years (Chen et al., 1990; Liewellyn et al., 2001; Schantz and Yu, 2002).

Many epidemiological studies conducted over the last three decades in America, Europe and Asia have provided strong evidence of an association between alcohol and tobacco use and an increased risk of oral and pharyngeal tumors (Madani et al., 2010; Blot et al., 1988; Franceschi et al., 1990; Zheng et al., 1990; 2004) but there was no report about the socio-demographic factors as independent risk for oral cancer in India. Hence, the aim of this study is to provide the socio-demographic factors of the oral cancer patients and compare it with age and gender matched healthy group as control. This will also help to find out whether the socio-demographic characteristics of the population play a role in the development of oral cancer.

MATERIALS AND METHODS

Setting of study: It was a hospital based case-control study, conducted at Morbai Naraindas Budharani Cancer Institute, Pune, India, during 2005-2006.

Study population: The subjects were selected using simple random sampling procedure. Cases were the new known patients of oral cancer aged above 18 years, diagnosed and confirmed by histopathological results and classified by the standard International Classification of Diseases (ICD-10) criterion. The controls were selected from the relatives, friends and neighborhoods of cases, who accompanied the patients referred to the hospital and cancer institute, who did not have cancer and thus apparently were healthy. The data related to demographic status and occupational was collected from both, cases as well as controls, after taking their written informed consent. The entire information was recorded through personal interview and semi-structured validated questionnaires.

A total of 700 subjects were taken for this study. Interviews were conducted in the local languages, including Hindi, Marathi and English with the help of a trained interpreter. Information related to education level was classified as illiterate, primary school (up to 5years education), middle school (6-8 years of education), secondary school (9-13. 12 years of education) and graduate (including both undergraduate and postgraduate).

Occupation was assessed according to respondents self reports and coded as follows; Agriculture, blue collar, white collar, self-employed, professional and unemployed. Income is categorized as less or more than 5000 Indian Rupees as monthly household income. Religion was in two categories, Hindu and others, while in terms of marital status it was 3 categories; married, unmarried and others. Tobacco use categorized as ever or never use of smoking and smokeless types. Alcohol and dietary habits also were assessed according to ever or never use of these factors.

Statistical methods: The data is presented as the numbers with percentage (prevalence) or mean with Standard Deviation (SD) as appropriate. The significance of difference between the proportions of qualitative characteristics is...

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