Spectrum of premalignant oral lesions in rural North Indian population at a tertiary care hospital
Keywords:Premalignant oral lesions, Leukoplakia, Oral submucous fibrosis, Rural, Adverse oral habits
Background: The objective of the study was to study the spectrum of premalignant oral lesions in rural North Indian population at a tertiary care hospital.
Methods: A total of 340 patients with oral lesions for more than 2 weeks were enrolled in the study. Patients with proven malignancy, white patch in the oral cavity which can be scrapped off, e.g. oral candidiasis and urban patients were excluded. Biopsy specimen was obtained from all the patients and evaluated histopathologically. Site, nature and type of oral lesion were determined. Demographic data and exposure to different risk factors was also noted. Findings were correlated using Chi-square test.
Results: Premalignant lesions were seen in 191 (56.18%) cases. They included leukoplakia (n=87; 45.5%), OSMF (n=62; 32.5%), Erythroplakia (n=18; 9.4%), lichen planus (n=15; 7.9%), melanoplakia/ melanosis (n=8; 4.2%) and DLE (n=1; 0.5%) respectively. Most common sites affected by premalignant lesions were buccal mucosa (n=173; 90.6%), retromolar area (n=42; 22%). Majority of patients with premalignant lesions were aged 26-50 years (78.5%), males (62.8%), farmers/labourers (56%) and illiterate/educated upto primary level (57.1%). Almost all the patients had two or more adverse oral habits with areca nut chewing being most common (69.6%) followed by tobacco chewing (66%) and smoking (60.2%) respectively. Majority had these addictions for >5 years (66%).
Conclusions: Leukoplakia and OSMF dominated the premalignant lesions in rural patients having low education and high prevalence of adverse oral habits for prolonged duration.
McDowell JD. An overview of epidemiology and common risk factors for oral squamous cell carcinoma. Otolaryngol Clin North Am. 2006;39(2):277-94.
Llewellyn CD, Johnson NW, Warnakulasuriya KA. Risk factors for squamous cell carcinoma of the oral cavity in young people--a comprehensive literature review. Oral Oncol. 2001;37(5):401-18.
deSouza C, Pawar U, Chaturvedi P. Precancerous Lesions of Oral Cavity. Otorhinolaryngol Clin: An Int J. 2009;1(1):7-17.
Nair DR, Pruthy R, Pawar U, Chaturvedi P. Oral cancer:Premalignant conditions and screening - an update. J Can Res Ther. 2012;8:57-66
Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ, et al (eds). SEER Cancer Statistics Review. 1975-2005,
Kiran KK, Saraswathi TR, Ranganathan K, Uma Devi M, Elizabeth J. Oral submucous fibrosis:A clinico-histopathological study in Chennai. Indian J Dent Res. 2007;18:106-11.
Joshi M, Tailor M. Prevalence of most commonly reported tobacco-associated lesions in central Gujarat: A hospital-based cross-sectional study. Indian J Dent Res. 2016;27:405-9.
Gupta M, Choudhary H, Gupta N, Gupta A. Histopathological study of neoplastic lesions of oral cavity and oropharynx. Int J Res Med Sci. 2016;4(5):1506-10.
Ambekar DM, Chaudhary BJ, Kulkarni VV. A study of prevalence of oral precancerous lesions in relation to tobacco habituation. 2014;5(1):282-5.
Mishra SS, Kale LM, Sodhi SJ, Mishra PS, Mishra AS. Prevalence of oral premalignant lesions and conditions in patients with tobacco and tobacco-related habits reporting to a dental institution in Aurangabad. J Indian Acad Oral Med Radiol. 2014;26:152-7.
Jagtap SV, Warhate P, Saini N, Jagtap SS, Chougule PG. Oral premalignant lesions: a clinicopathological study. Int Surg J. 2017;4(10):3477-81.
Kumar YS, Acharya S, Pentapati KC. Prevalence of oral potentially malignant disorders in workers of Udupi taluk. South Asian J Cancer. 2015;4:130-3.
Kumar S, Debnath N, Ismail MB, Kumar A, Kumar A, Badiyani BK, et al. Prevalence and Risk Factors for Oral Potentially Malignant Disorders in Indian Population. Adv Prevent Med. 2015;208519:1-7.
Narasannavar A, Wantamutte AS. Prevalence of oral precancerous lesions and conditions among tobacco consumers in rural population around Belgaum. A community based cross sectional study. IOSR J Dental Med Sci. 2014;13(4):31-4.
Mishra M, Mohanty J, Sengupta S, Tripathy S. Epidemiological and clinicopathological study of oral leukoplakia. Indian J Dermatol Venereol Leprol. 2005;71:161-5.
Waldron CA, Shafer WG. Leukoplakia revisited: A clinicopathologic study of 3256 oral leukoplakias. Cancer. 1975;36:1386-92.
Kumar A, Birua C, Kant C. A Study on Clinicoetiopathogenesis of Oral Precancerous Lesion in Jharkhand. Int J Contemp Med Res. 2016;3(9):2691-3.
Gupta S, Singh R, Gupta OP, Tripathi A. Prevalence of oral cancer and pre-cancerous lesions and the association with numerous risk factors in North India: A hospital based study. Natl J Maxillofac Surg. 2014;5:142-8.
Khan Y, Birare SD. Study of Histopathology of the Tumour like Lesions and Tumours of the Oral Cavity. Int J Sci Res. 2016;5(4):915-20.