• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5195-5199
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• 2012

Objectives: Global cancer statistical data show that India has one of the highest incidence rates of oral cancer worldwide. Early detection is extremely important as it results in lower morbidity and death rates. The present study was undertaken to assess awareness of oral cancer and knowledge of its early signs and risk factors in the general public of the semi-urban Gorakhpur area of Uttar Pradesh (India). It was also intended to educate the same population for early detection by increasing their ability to recognize signs and risk factors. Method: A questionnaire-based household survey was conducted over a period of one month in different parts of Gorakhpur district, a region where tobacco use is apparently very high. A total of 2,093 persons participated in the survey. The collected data were analyzed using SPSS software to assess and associate oral cancer awareness with the prevalence, and abstract risk factors, as well as other confounding variables. Results: The general awareness, knowledge of signs and risk factors of oral cancer were found to be proportionate to the literacy level with the highest rate of awareness being among high school and graduates and lowest among illiterates. It was also observed that on most of these dimensions the younger age groups (<30 years) were significantly more knowledgeable. Conclusion: Overall, the awareness of oral cancer in the high-risk population of Gorakhpur was not satisfactory, pointing to a need for further dissemination of information on this issue and its associated risks. This is especially important for the youngsters, as this may possibly help them keep away from the deleterious habit of tobacco indulgence in any form. If necessary risk factor cessation counselling should be provided.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8183-8189
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• 2014

Background: A comparative cross-sectional study involving oral cancer patients and healthy individuals was designed to investigate associations between retinol, ${\alpha}$-tocopherol and ${\beta}$-carotene with the risk of oral cancer. Materials and Methods: This study included a total of 240 matched cases and controls where subjects were selected from the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). Retinol, ${\alpha}$-tocopherol and ${\beta}$-carotene levels and intake were examined by high-performance liquid chromatography (HPLC) and food frequency questionnaire (FFQ) respectively. Results: It was found that results from the two methods applied did not correlate, so that further analysis was done using the HPLC method utilising blood serum. Serum levels of retinol and ${\alpha}$-tocopherol among cases ($0.177{\pm}0.081$, $1.649{\pm}1.670{\mu}g/ml$) were significantly lower than in controls ($0.264{\pm}0.137$, $3.225{\pm}2.054{\mu}g/ml$) (p<0.005). Although serum level of ${\beta}$-carotene among cases ($0.106{\pm}0.159{\mu}g/ml$) were lower compared to controls ($0.134{\pm}0.131{\mu}g/ml$), statistical significance was not observed. Logistic regression analysis showed that high serum level of retinol (OR=0.501, 95% CI=0.254-0.992, p<0.05) and ${\alpha}$-tocopherol (OR=0.184, 95% CI=0.091-0.370, p<0.05) was significantly related to lower risk of oral cancer, whereas no relationship was observed between ${\beta}$-carotene and oral cancer risk. Conclusions: High serum levels of retinol and ${\alpha}$-tocopherol confer protection against oral cancer risk.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5087-5090
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• 2012

Oral cancer is a common site of head and neck cancer, and is relatively frequent in Northeast Thailand. The objective of this hospital-based, case-control study was to determine associations with risk factors. A total of 104 oral cancer cases diagnosed between July 2010 and April 2011 in 3 hospitals were matched with control subjects by age, sex and hospital. Data were collected by personal interview. There were significant associations between oral cancer and tobacco smoking (OR=4.47; 95%CI=2.00 to 9.99), alcohol use among women (OR=4.16; 95%CI=1.70 to 10.69), and betel chewing (OR=9.01; 95%CI=3.83 to 21.22), and all three showed dose-response effects. Smoking is rare among Thai women (none of the control women were smokers), but betel chewing, especially among older women, is relatively common. We did not find any association between practicing oral sex and oral cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3957-3960
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• 2015

Background: Several studies have examined the relationship between oral contraceptive pill (OCP) use, abortions and breast cancer, with mixed results. Hormonal changes associated with OCP use and abortion may increase risk of breast cancer over time, but there is a lack of studies studying this association in Saudi Arabian women. Materials and Methods: We thererfore conducted a case control study in 192 women (92 as cases and 100 as controls), aged 30 to 65, and collected information on variables including examples related to study objectives and those which may confound findings. The Chi square test was used to detect associations between various factors and risk of breast cancer. Results: We found no evidence of interaction between history of abortion or frequency of abortion and breast cancer risk (Chi square=0.422, p =0.420 and 1, p =0.169) respectively. Oral contraceptives did not confer risk for breast cancer overall (OR=0.276, 95%CI 0.092-0.829, p=0.524), while long term use of OCP was associated with increased risk of breast cancer (OR=0.297, 95%CI 0.158-0.557, p=0.001), with higher association for those who used 10 years or more of OCPs (OR=0.282, 95%CI 0.095-0.835, p=0.02). Age at first use of OCPs had no effect on breast cancer risk (p=0.452) or age at diagnosis (p=0.074). Conclusions: Prolonged use of OC (more than 10 years) may be associated with increased risk of breast cancer in Saudi women. Larger population based studies are needed to confirm this finding in this population.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5567-5577
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• 2013

The prevalence of oral cancers (OC) is high in Asian countries, especially in South and Southeast Asia. Asian distinct cultural practices such as betel-quid chewing, and varying patterns of tobacco and alcohol use are important risk factors that predispose to cancer of the oral cavity. The aim of this review is to provide an update on epidemiology of OC between 2000 and 2012. A literature search for this review was conducted on Medline for articles on OC from Asian countries. Some of the articles were also hand searched using Google. High incidence rates were reported from developing nations like India, Pakistan, Bangladesh, Taiwan and Sri Lanka. While an increasing trend has been observed in Pakistan, Taiwan and Thailand, a decreasing trend is seen in Philippines and Sri Lanka. The mean age of occurrence of cancer in different parts of oral cavity is usually between 51-55 years in most countries. The tongue is the leading site among oral cancers in India. The next most common sites in Asian countries include the buccal mucosa and gingiva. The 5 year survival rate has been low for OC, despite improvements in diagnosis and treatment. Tobacco chewing, smoking and alcohol are the main reasons for the increasing incidence rates. Low socioeconomic status and diet low in nutritional value lacking vegetables and fruits contribute towards the risk. In addition, viral infections, such as HPV and poor oral hygiene, are other important risk factors. Hence, it is important to control OC by screening for early diagnosis and controlling tobacco and alcohol use. It is also necessary to have cancer surveillance at the national-level to collect and utilise data for cancer prevention and control programs.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1957-1963
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• 2013

Objective: To assess oral cancer awareness, its associated factors and related sources of information among a selected group of Malaysians. Methods: A cross-sectional survey was conducted on all Malaysian ethnic groups aged ${\geq}15$ years old at eight strategically chosen shopping malls within a two week time period. Data were analysed using chi-square tests and multiple logistic regression. Significance level was set at ${\alpha}$ <0.05. Results: Most (84.2%) respondents had heard of oral cancer. Smoking was the most (92.4%) recognized high risk habit. Similar levels of awareness were seen for unhealed ulcers (57.3%) and red/white patches (58.0%) as signs of oral cancer. Age, gender, ethnicity, marital status, education, occupation and income were significantly associated with oral cancer awareness (p<0.05). Conclusions: There was a general lack of awareness regarding the risk habits, early signs and symptoms, and the benefits of detecting this disease at an early stage. Mass media and health campaigns were the main sources of information about oral cancer. In our Malaysian population, gender and age were significantly associated with the awareness of early signs and symptoms and prevention of oral cancer, respectively.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.3001-3006
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• 2016

Background: The cancer progression of oral leukoplakia is an important watchpoint in the follow-up observation of the patients. However, potential malignancies of oral leukoplakia cannot be estimated by histopathologic assessment alone. We evaluated genetic abnormalities at the level of copy number variation (CNV) to investigate the risk for developing cancer in oral leukoplakias. Materials and Methods: The current study used 27 oral leukoplakias with histological evidence of dysplasia. The first group (progressing dysplasia) consisted of 7 oral lesions from patients with later progression to cancer at the same site. The other group (non-progressing dysplasia) consisted of 20 lesions from patients with no occurrence of oral cancer and longitudinal follow up (>7 years). We extracted DNA from Formalin-Fixed Paraffin-Embedded (FFPE) samples and examined chromosomal loci and frequencies of CNVs using Taqman copy number assays. Results: CNV frequently occurred at 3p, 9p, and 13q loci in progressing dysplasia. Our results also indicate that CNV at multiple loci-in contrast to single locus occurrences-is characteristic of progressing dysplasia. Conclusions: This study suggests that genetic abnormalities of the true precancer demonstrate the progression risk which cannot be delineated by current histopathologic diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.953-958
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• 2015

Background: Expression of KRT13, FAIM2 and CYP2W1 appears to be influenced by risk habits, thus exploring the associations of these genes in oral squamous cell cancer (OSCC) with risk habits, clinico-pathological parameters and patient survival may be beneficial in identifying relevant biomarkers with different oncogenic pathways. Materials and Methods: cDNAs from 41 OSCC samples with and without risk habits were included in this study. Quantitative real-time PCR was used to analyze KRT13, FAIM2 and CYP2W1 in OSCC. The housekeeping gene (GAPDH) was used as an endogenous control. Results: Of the 41 OSCC samples, KRT13 was down-regulated in 40 samples (97.6%), while FAIM2 and CYP2W1 were down-regulated in 61.0% and 48.8%, respectively. Overall, there were no associations between KRT13, FAIM2 and CYP2W1 expression with risk habits, selected socio-demographic and clinico-pathological parameters and patient survival. Conclusions: Although this study was unable to show significance, there were some tendencies in the associations of KRT13, FAIM2 and CYP2W1 expression in OSCC with selected clinic-pathological parameters and survival.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6755-6760
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• 2014

Background: Oral cancer is a common form of cancer in India, particularly among men. About 95% are squamous cell carcinomas. Tobacco along with alcohol are regarded as the major risk factors. Objectives: (i) To determine associations of oral squamous cell carcinoma (OSCC) with respect to gender, age group, socioeconomic status and risk habits; (ii) To observe the distribution of affected oral anatomical sites and clinico-pathological profile in OSCC patients. Materials and Methods: This is an unmatched case-control study during period January 2012 to December 2013. Total of 471 confirmed OSCC patients and 556 control subjects were enrolled. Data on socio-demography, risk habits with duration and medical history were recorded. Results: There were significant associations between OSCC with middle age (41-50years; unadjusted OR=1.63, 95%CI=1.05-2.52, p=0.02) (51-60 years; unadjusted OR=1.79, 95%CI=1.15-2.79, p=0.009) and male subjects (unadjusted OR=2.49, 95%CI=1.89-3.27, p=0.0001). Cases with both habits of tobacco chewing and smoking were at a higher risk for OSCC than tobacco chewing alone (unadjusted OR=0.52, 95%CI=0.38-0.72, p=0.0001), duration of risk habits also emerged as a responsible factor for the development of carcinoma. The majority of patients were presented in well-differentiated carcinomas (39.9%). Prevalence of advance stages (TNM stage III, IV) was 23.4% and 18.3% respectively. The buccal mucosa was the most common (35.5%) affected oral site. Conclusions: In most Asian countries, especially India, there is an important need to initiate the national level public awareness programs to control and prevent oral cancer by screening for early diagnosis and support a tobacco free environment.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7243-7249
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• 2013

Numerous studies have been conducted regarding association between TNF-${\alpha}$ and oral cancer risk, but the results remain controversial. The present meta-analysis is performed to acquire a more precise estimation of relationships. Databases of Pubmed, the Cochrane library and the China National Knowledge Internet (CNKI) were retrieved until August 10, 2013. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated with fixed- or random-effect models. The heterogeneity assumption was assessed by I-squared test. Among the eight included case-control studies, all were focused on TNF-${\alpha}$-308G>A and four also concerned the TNF-${\alpha}$-238G>A polymorphism. It was found that oral cancer risk were significant decreased with the TNF-${\alpha}$-308G>A polymorphism in the additive genetic model (GG vs. AA, OR=0.19, 95% CI: [0.04, 1.00], P=0.05, I2=68.9%) and the dominant genetic model (GG+GA vs. AA, OR=0.22, 95% CI: [0.06, 0.82], P=0.03, I2=52.4%); however, no significant association was observed in allele contrast (G vs. A, OR=0.70, 95% CI: [0.23, 2.16], P=0.54, I2=95.9%) and recessive genetic models (GG vs. GA+AA, OR=0.72, 95% CI: [0.33, 1.57], P=0.41, I2=93.1%). For the TNF-${\alpha}$-238G>A polymorphism, significant associations with oral cancer risk were found in the allele contrast (G vs. A, OR=2.75, 95% CI: [1.25, 6.04], P=0.01, I2=0.0%) and recessive genetic models (GG vs. GA+AA, OR=2.23, 95%CI: [1.18, 4.23], P=0.01, I2=0.0%). Conclusively, this meta-analysis indicates that TNF-${\alpha}$ polymorphisms may contribute to the risk of oral cancer. Allele G and the GG+GA genotype of TNF-${\alpha}$-308G>A may decrease the risk of oral cancer, while allele G and the GG genotype of TNF-${\alpha}$-238G>A may cause an increase.