Risk Assessment of Smokeless Tobacco among Oral Pre-cancer and Cancer Patients in Eastern Developmental Region of Nepal

Abstract

Background: Oral potentially malignant disorders (OPMDs) and oral cancer are prevalent in the community mostly due to the popularity of tobacco and betel quid chewing practice in Nepal. The study was conducted to assess the prevalence of oral pre-cancer/cancer in eastern developmental region; identify the oral pre-cancer and cancer in tobacco chewers and assess the risk. Methods: Cross-sectional epidemiological study with nested case-control study was done among 16-70 years old, taking 3200 participants (200 from each of the 16 districts). Results: More than 40% either chewed areca nut and/or tobacco. There is high prevalence of oral cancer, and/or Oral Potentially Malignant Disorders (OPMD). Chewing areca nut, tobacco, commercial areca nut/tobacco preparation, and smoking are the major risk factors for oral potentially malignant disorders, and oral cancer in the population studied. Areca nut chewing with or without tobacco consumption emerged as the strongest risk factor for OPMD and oral cancer. Oral hygiene was also strongly associated with these oral diseases. Conclusions: There is need of oral examination on a routine basis, due to high prevalence of oral disease. Further similar study is needed to include population in other parts of the country. Keywords: cancer; oral cancer; oral diseases; oral hygiene; pre-cancer; prevalence; risk factor; tobacco chewers.