Challenges in global improvement of oral cancer outcomes: findings from rural Northern India
More details
Hide details
Dept. of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard, Boston, USA
Dept. of Epidemiology, Harvard School of Public Health, Harvard, Boston, USA
Dept. of Oral Epidemiology and Biostatistics, Columbia University College for Dental Medicine, Columbia, New York, USA
Athanasios I. Zavras   

Dept. of Epidemiology, Harvard School of Public Health, Harvard, Boston, MA
Publication date: 2012-04-12
Tobacco Induced Diseases 2012;10(April):5
In India, 72% of the population resides in rural areas and 30-40% of cancers are found in the oral cavity. The majority of Haryana residents live in villages where inadequate medical facilities, no proper primary care infrastructure or cancer screening tools and high levels of illiteracy all contribute to poor oral cancer (OC) outcomes. In this challenging environment, the objective of this study was to assess the association between various risk factors for OC among referrals for suscipious lesions and to design and pilot test a collaborative community-based effort to identify suspicious lesions for OC.

Setting: Community-based cross sectional OC screening. Participants: With help from the Department of Health (DOH), Haryana and the local communities, we visited three villages and recruited 761 participants of ages 45-95 years. Participants received a visual oral cancer examination and were interviewed about their dental/medical history and personal habits. Pregnant women, children and males/females below 45 years old with history of OC were excluded. Main outcome: Presence of a suspicious oral lesion.

Out of 761 participants, 42 (5.5%) were referred to a local dentist for follow-up of suspicious lesions. Males were referred more than females. The referral group had more bidi and hookah smokers than non smokers as compared to non referral group. The logistic regression analysis revealed that smoking bidi and hookah (OR = 3.06 and 4.42) were statistically significant predictors for suspicious lesions.

Tobacco use of various forms in rural, northern India was found to be quite high and a main risk factor for suspicious lesions. The influence of both the DOH and community participation was crucial in motivating people to seek care for OC.

Census of India: 2007.
WHO: Tobacco or Health: A Global status report: Country presentations at various Regional Meetings on Tobacco 1997-1998. 1997, Geneva.
Madani AH, Sotoodeh Jahromi A, Dikshit M, Bhaduri D: Risk Assessment of Tobacco Types and Oral Cancer. Am J Pharmacol Toxicol. 2010, 5: 9-13. 10.3844/ajptsp.2010.9.13.
Gupta PC, Ray CS: Smokeless tobacco and health in India and South Asia. Respirology. 2003, 8: 419-431. 10.1046/j.1440-1843.2003.00507.x.
Sankaranarayanan R, Swaminathan R, Black RJ: Cancer survival in developing countries. Cancer. 1996, 78 (12): 2461-4. 10.1002/(SICI)1097-0142(19961215)78:12<2461::AID-CNCR2>3.0.CO;2-N.
Sankaranarayanan R, Mathew B, Jacob BJ, Thomas G, Somanathan T, Pisani P, Pandey M, Ramadas K, Najeeb K, Abraham E: Early findings from a community-based, cluster-randomized, controlled oral cancer screening trial in Kerala. India. The Trivandrum Oral Cancer Screening Study Group. Cancer. 2000, 88 (3): 664-73.
Bandason T, Rusakaniko S: Prevalence and associated factors of smoking among secondary school students in Harare Zimbabwe. Tobacco Induced Diseases. 2010, 8: 12-10.1186/1617-9625-8-12.
Kamangar F, Chow WH, Abnet CC, Dawsey SM: Environmental causes of esophageal cancer. Gastroenterol Clin North Am. 2009, 38: 27-57. 10.1016/j.gtc.2009.01.004.
Nasrollahzadeh D, Kamangar F, Aghcheli K, Sotoudeh M, Islami F, Abnet CC, Shakeri R, Pourshams A, Marjani HA, Nouraie M, Khatibian M, Semnani S, Ye W, Boffetta P, Dawsey SM, Malekzadeh R: Opium, tobacco, and alcohol use in relation to oesophageal squamous cell carcinoma in a high-risk area of Iran. Br J Cancer. 2008, 98 (11): 1857-63. 10.1038/sj.bjc.6604369.
Increasing popularity of waterpipe tobacco smoking and electronic cigarette use: Implications for oral healthcare
C. Ramôa, T. Eissenberg, S. Sahingur
Journal of Periodontal Research
Toxicological impact of waterpipe smoking and flavorings in the oral cavity and respiratory system
Fawad Javed, Shatha ALHarthi, Munerah BinShabaib, Sangeeta Gajendra, Georgios Romanos, Irfan Rahman
Inhalation Toxicology
A descriptive study of the perceptions and behaviors of waterpipe use by university students in the Western Cape, South Africa
Karin Daniels, Nicolette Roman
Tobacco Induced Diseases
Recommendations for screening and early detection of common cancers in India
Preetha Rajaraman, Benjamin Anderson, Partha Basu, Jerome Belinson, Anil Cruz, Preet Dhillon, Prakash Gupta, Tenkasi Jawahar, Niranjan Joshi, Uma Kailash, Sharon Kapambwe, Vishwa Katoch, Suneeta Krishnan, Dharitri Panda, R Sankaranarayanan, Jerard Selvam, Keerti Shah, Surendra Shastri, Krithiga Shridhar, Maqsood Siddiqi, Sudha Sivaram, Tulika Seth, Anurag Srivastava, Edward Trimble, Ravi Mehrotra
The Lancet Oncology
Proteomic Changes in Oral Keratinocytes Chronically Exposed to Shisha (Water Pipe)
Shankargouda Patil, Tejaswini Subbannayya, Sonali Mohan, Niraj Babu, Jayshree Advani, Gajanan Sathe, Pavithra Rajagopalan, Krishna Patel, Shilpa Bhandi, Hitendra Solanki, David Sidransky, Harsha Gowda, Aditi Chatterjee, Marco Ferrari
OMICS: A Journal of Integrative Biology
Association between tobacco waterpipe smoking and head and neck conditions
Teja Munshi, Carolyn Heckman, Susan Darlow
The Journal of the American Dental Association
Syringic acid may attenuate the oral mucosal carcinogenesis via improving cell surface glycoconjugation and modifying cytokeratin expression
Velu Periyannan, Vinothkumar Veerasamy
Toxicology Reports
Harmful effects of shisha: literature review
Hafiz Aslam, Shafaq Saleem, Sidra German, Wardah Qureshi
International Archives of Medicine
Water pipe smoking and dermatologic consequences
U. Wollina
Journal of the European Academy of Dermatology and Venereology
The role of tobacco use on dental care and oral disease severity within community dental clinics in Japan
Miki Ojima, Takashi Hanioka, Kaoru Shimada, Satoru Haresaku, Mito Yamamoto, Keiko Tanaka
Tobacco Induced Diseases
The effects of waterpipe tobacco smoking on health outcomes: an updated systematic review and meta-analysis: Table 1.
Reem Waziry, Mohammed Jawad, Rami Ballout, Akel Al, Elie Akl
International Journal of Epidemiology
Embedded system for a battery-operated LED-based photodynamic therapy device for treatment of early-stage oral cancers in resource-limited settings
Liam Daly, Grant Rudd, Hui Liu, Paola Leon, Jonathan Celli, Filip Cuckov
2017 2nd International Conference on Bio-engineering for Smart Technologies (BioSMART)
The interaction between tobacco use and oral health among tribes in central India
Sunali Khanna
Tobacco Induced Diseases
Health effects associated with waterpipe smoking
Ziad El-Zaatari, Hassan Chami, Ghazi Zaatari
Tobacco Control
Health Effects of Waterpipe Tobacco Use: Getting the Public Health Message Just Right
Mohammed Ali, Mohammed Jawad
Tobacco Use Insights
Textbook of Oral Cancer
Mia Hashibe