Oral Squamous Cell Carcinoma and Tobacco Use

Aims: To determine the prevalence of tobacco chewing and smoking in patients diagnosed with OSCC as well as to observe the localization of OSCC, staging and grading of OSCC at the time of diagnosis.

Study Design: This is a cross-sectional study.

Place and Duration of Study: The study was conducted at Ziauddin dental hospital KDLB and Clifton Campus, Karachi from October 2017 to April 2018.

Methodology: Variables like age, gender, ethnicity, and socioeconomic status were noted along with the detail history of different types of tobacco used, oral hygiene habits, and family history of cancer. The stage and grade of oral cancer were interpreted from the biopsy and CT scan reports according to the CAP protocol. Quantitative variables were presented as mean and standard deviation. For categorical data frequency and percentages was calculated.

Results: The oral cancer cases comprised of 38(81%) males and 9(19%) females with mean age of 49 years. The most common location of oral cancer in this study was the buccal mucosa followed by tongue and lips. The majorly consumed type of tobacco was gutka in 55% of patients followed by pan in 30%, naswar in 15%, betel nut in 11% and smoking in 11% among OSCC cases. Histological reports showed that there were equal number of moderately and poorly differentiated OSCC (n=16; 34%). According to TNM staging, in our study stage II was 34%, followed by stage I that was 32%.

Conclusion: It can be concluded that the major etiological factors of OSCC among Pakistani population are chewing tobacco habits including gutka, pan, naswar, betel nut and smoking with male predominance. The incidence of OSCC can be reduced by raising oral cancer awareness among general population about carcinogenic effect of tobacco chewing and smoking and also by encouraging dental and medical professionals to conduct free oral cancer screenings.