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Indian Journal of Community Medicine

Prevalence of Oral Precancerous Lesions in Tobacco of Naigaon, Mumbai

Author(s): KS Talole, SS Bansode, MB Patki

Vol. 31, No. 4 (2006-10 - 2006-12)

Oral cancer is a major health problem in tobacco users all over the world1. Tobacco smoke and unburnt tobacco used in chewing / snuff contain hydrocarbons and several potent nitrosamines which are DNA toxic carcinogens and play a key role in initiation and promotion of oral cancers2. Many associated risk factors, for developing oral cancers and precancerous lesions, such as using spices, poor oral hygiene, alcohol use, and ill-fitting dentures etc. are commonly observed in people of our country. Present study was conducted to determine the prevalence of oral cancers and precancerous lesions in the Naigaon community The cross-sectional study was conducted during the months of November-December 2004, and 3320 houses were surveyed. Out of the 1974 tobacco users 200 tobacco users were selected for the final study for screening the oral cancerous and precancerous lesions.

Standard Trained Principal Investigator conducted a house to house survey and screened the study population for precancerous lesions using, Total 480 houses were visited by systematic random technique for screening the lesions, to cover the sample size of 200 (arbitrarily decided).Predesigned questionnaire was used. Their clinical examination (oral cavity, oropharynx and neck, was then conducted. Free and voluntary informed consent was taken. Personal privacy and confidentiality was maintained.

Of the 200 subjects examined precancerous lesions were found in 106 tobacco users of Naigaon community. The prevalence was thus 53% (Table I). Most of the cases were in the age group of 45-55 yrs. Only four types of lesions were found in the study group-leukoplakia, few cases of erythroplakia, tobacco pouch stomatitis and oral submucous fibrosis. It was probably because of the small sample size, that no case of cancerous lesion was found. In males no significant increase in risk with increasing age was observed. However, in females risk was found to increase with increasing age.

Table I. Sex-Wise Distrinution of Lesions

Lesions Male
(n = 81)
(n = 119)
(n = 200)
Leukoplakia /
18 (48.65%) 39(56.52%) 57(53.77%)
7(18.92%) 15 (21.74%) 22 (20.75%)
Tobacco Pouch
12 (32.43%) 15 (21.74%) 27 (25.47%)
Total 37

Risk with >5 times/day use of tobacco was found to be approximately 8 times than that with <5 times/day use, and risk with >10 yrs of consumption of tobacco was around 5 times that with <10 yrs of consumption. (Table II) Alcohol, jagged tooth and ill-fitting appliances were found to increase the risk of oral cancers. There fourth of the lesions were found to be asymptomatic. The participants with symptomatic lesions had nonspecific symptoms such as pain, slight trismus and few were aware of the presence of specific signs such as white patches, but none of them was aware of the lesions being precancerous, so they simply ignored and had never visited the doctor for the same complaints.

Precancerous lesions constitute a major health problem in tobacco users of Naigaon community. Most cases being asymptomatic require awareness program regarding prevention and early detection.

These results however, can not be applied to the general population, as overall, the study was based on tobacco users only.

Table II. Distribution of Lesions According to Frequency and Duration of Consumption of Tobacco.

Frequency of consumption Lesions Present Lesion Absent Total
>5 times / day 82 (a) 28 (b) 110
<5 times / day 24© 66 (d) 90
Duration of Consumption
>10 yrs 101 (a) 76 (b) 177
>10 yrs 18 (d) 23
Total 106 94 200


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  2. Datta K, Saha R K, Chakrabarti R N. A simple risk estimates study for oral cavity cancer: practical approach in Indian context. Journal Of Indian Medical Association. 1997; 95: 70-71.
  3. Bhowate RR, Jawle SS, Rao SP, Pakhan AJ, Chinchkhede DH. Epidenmiology of oral premailigant lesions in rural areas of Wardha District. International Congress on Oral Caner, Madras. Macmillan India, Bangalore, 1991. Oral Oncology; 1991; 2:24-27.
  4. Web site for CA: A Cancer Journal for Clinicians 1965 – 2005 – date of accros: 21/12/2004.
  5. Squamous Cell Carcinoma Presenting as Erythroleukoplakia – http://www.thejcdp/com/issue/021/ case21/choice_c_new.htm-date of access: 21/12/2004.

KS Talole, SS Bansode, MB Patki
Department Of Preventive And Social Medical, Seth G.S. Medical College, K.E.M. Hospital, Parel, Mumbai -12.
Email: [email protected]
Received: 21-2-05

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