Association between Lifestyle Factors and Oral Potentially Malignant Disorders among People of Bangalore: A Case-control Study

Abstract

Introduction: The increase in prevalence of oral premalignant lesions and oral cancer in India is due to cultural, ethnic, geographic factors and varying lifestyle factors like consumption of tobacco, alcohol and standard of living. Some of the risk factors are modifiable and emphasises the need for detailed assessment of these modifiable risk factors and increasing awareness among general public and policy makers. Aim: The present study was conducted to assess the association between lifestyle factors and Oral Potentially Malignant Disorders (OPMDs). Materials and Methods: A case-control study was conducted where 154 cases and controls were selected from MS Ramaiah Dental College and Hospital, Bangalore and peripheral outreach centers of MS Ramaiah Dental College and Hospital, Bangalore. Cases diagnosed as oral leukoplakia, erythroplakia and Oral Submucous Fibrosis (OSMF) based on the World Health Organisation (WHO) criteria (1980) were included in the study group. Age and sex (1:1) matched controls without OPMDs were included in control group. The data was collected regarding socio-demographic factors, blood group and lifestyle factors using specially designed proforma. Chi-square test and odds ratio were utilised to association and strength of association between various lifestyle factors and development of OPMDs. Univariate logistic regression test was done followed by multiple logistic regression for identifying the risk factors. The p-value <0.05 was considered as statistically significant. SPSS version 11.0 was used for data analysis. Results: Out of 154 cases, 84 (54.5%) cases were leukoplakia, 2 (1.3%), cases were erythroplakia, 53 (34.4%) cases were OSMF and 15 (9.7%) cases were with multiple potentially malignant disorders (leukoplakia+OSMF). In univariate analysis, OR for tobacco smoking in individuals who smoked more than 20 times a day was 2.56 (95% CL 1.19-5.5) compared to non-smokers, tobacco chewing who chewed more than 10 times a day was 43.03 (95% CL-17.2-107) in comparison to non-chewers and alcohol consumption who consumed alcohol daily was 3.2 (95% CL 0.6-16.3) in comparison to non-alcoholics. Following multiple logistic regression analysis occupation, smoking, chewing tobacco and vegetable intake was found to be statistically significant as independent risk factors p<0.05. Conclusion: Occupation, smoking, chewing tobacco and vegetable consumption were identified as independent risk factors for the development of OPMDs. Identifying the risk factors and OPMD at an early stage is important for prevention of oral cancer.