A study of etiopathological factors affecting oral malignancy


  • Ritesh Mahajan Department of Otorhinolaryngology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • Saleem Saeed Department of Otorhinolaryngology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • T. M. Nagaraj Department of Otorhinolaryngology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India




Malignancies of oral cavity, Etiopathological factors of oral malignancy, Prevention of oral malignancy


Background: Malignancies of oral cavity are quite common in India and other developing countries. Oral cancer is one of the ten most common cancers and oral cavity is the second most common site of primary tumors involving head and neck. In this study, we studied etiopathological factors affecting oral malignancy with a view to determine a correlation between the host and environment and additional stress put on oral tissue by social and nutritional factors of population.

Methods: A prospective study was conducted and data for the study was collected from patients presenting with oral malignancy/dysplasia. An informed written consent was taken from patient, and cases meeting the selection criteria were included in the study. A detailed history and a thorough clinical examination were done in about 50 patients.  

Results: A total of 50 cases were studied over a period of 18 months. Among study subjects 64% were in the age group ≥50 years. Commonest site involved was buccal mucosa with a preponderance over right side. Chewing was a commonest addictive habits among study subjects. Histopathologically 98% of cases turned out to be “squamous cell carcinoma” of varying differentiation.

Conclusions: Because of different life styles, habits and customs, poor oral hygiene among illiterates compared to literate’s oral malignancies are still a major health problem in developing countries like India. Timely surveys and registry programmes will give changing trends in such a grievous health issue.


Elango JK, Gangadharan P, Sumithra S, Kuriakose MA. Trends of head and neck cancers in urban and rural India. Asian Pacific J Cancer Prevention. 2006;7:1:108–12.

Schuller DE, Schleuning AJ. Deweese and Saunders' Otolaryngology - Head and Neck Surgery. St. Louis, Mosby. 8th ed. 1994; 199

National Cancer Registry Programme. Indian Council of Medical Research, 2013.

Coelho KR. Challenges of the oral cancer burden in India. J Cancer Epidemiol. 2012;2012:701932.

Nandakumar A, Thimmasetty KT, Sreeramareddy NM, Venugopal TC, Rajanna AT, Vinutha, et al. A population-based case-control investigation on cancers of the oral cavity in Bangalore, India. Br J Cancer. 1990;62(5):847–51.

Patel DR. Smoking and children. Indian J Pediatrics. 1999;66:817-24.

Gupta PC. Gutka: a major new tobacco hazard in India. Tob Control. 1999;8(2):132.

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.

Krishna Rao SV, Mejia G, Roberts-Thomson K, Logan R. Epidemiology of oral cancer in Asia in the past decade--an update (2000-2012). Asian Pac J Cancer Prev. 2013;14(10):5567-77.

Gupta B, Ariyawardana A, Johnson NW. Oral cancer in India continues in epidemic proportions: evidence base and policy initiatives. Int Dent J. 2013;63(1):12–25.

Reddy CR. carcinoma of the hard palate in India in relation to reverse smoking of chuttas. J Natl Cancer Inst. 1974;53(3):615-9.

Rao DN, Desai PB. Risk assessment of tobacco, alcohol and diet in cancers of base of tongue and oral tongue-a case control study. Indian J Cancer. 1998;35(2):65-72.

Van der Waal, de Bree R, Brakenhoff R, Coebergh JW. Early diagnosis in primary oral cancer: is it possible. Med Oral Potol Oral Cir Bucal. 2011;16(3):300-5.

Vidya Sagar MS, Fernandes DJ, Kasturi DP, Akhileshwaran R, Rao K, Rao S, et al. Radiotherapy and verrucous carcinoma of oral cavity-A study of 101 cases, Acta Oncol. 1992;31:43-7.

Cancela Mde C, Ramadas K, Fayette JM, Thomas G, Muwonge R, Chapuis F, et al. Alcohol intake, oral cavity cancer risk among men in a Prospective study in Kerala, India. Community Dent Oral Epidemiol. 2009;(37):342-9.

Adeyeni BF, Kolude B. Clinical presentation of oral squamous cell carcinoma. Niger Postgrad Med. 2013;20(2):108-10.

Madani AH, Jahromi AS, Dikshit M, Bhaduri D. Risk assessment of tobacco types, oral cancer. Am J Pharmacol Toxicol. 2010;5(1):9-13.

Balaram P, Sridhar H, Rajkumar T, Vaccarella S, Herrero R, Nandakumar A, et al. Oral cancer in south India: the influence of smoking, drinking, pan-chewing and oral hygiene. Ijc. 2002;98(3):440-5.

Muwonge R, Ramadas K, Sankila R, Thara S, Thomas G, Vinoda J, et al. Role of tobacco smoking, chewing and alcohol drinking in the risk of oral cancer in Trivandrum, India; a nested case-control design using incident cancer case. J Oral Oncol. 2008;44(5):446-54.

Orr IM. Oral cancer in betel chewer′s in Travancore, its aetiology, pathology and treatment. Lancet. 1933;2:575-80.

Sankaranarayanan R, Ramadas K, Thomas G, Muwonge R, Thara S, Mathew B, et al. Effect of screening on oral cancer mortality in Kerala, India: a cluster-randomised controlled trial. Lancet 2005;365(9475):1927–33.

Wahi PN, Kehar U, Lahiri B. Factors influencing oral and oropharyngeal cancer in India. Br J Cancer. 1965;19(4):642–60.

Manjari M, Popli R, Paul S, Gupta VP, Kaholon SK. Prevalence of oral cavity, pharynx, larynx and nasal cavity malignancies in Amritsar, Punjab. Indian J Otolaryngol Head Neck Surg. 1999;48:191-5.

Tandon A, Bordoloi B, Jaiswal R, Srivastava A, Singh RB, Shafique U. Demographic and clinicopathological profile of oral squamous cell carcinoma patients of North India: A retrospective institutional study. SRM J Res Dent Sci. 2018;9:114-8.

Paymaster JC. Cancer of the buccal mucosa, a clinical study of 650 cases in Indian patients. Cancer. 1956;9:431–5.

Shenoi R, Devrukhkar V, Chaudhuri, Sharma BK, Sapre SB, Chikhale A. A democratic and clinical profile of oral squamous cell carcinoma patients: a retrospective study. Indian J Cancer. 2012;49(1):21-6.

Singhania V, Jayade BV, Anehosur V, Gopalkrishnan K, Kumar N. Carcinoma of buccal mucosa: a site specific clinical audit. Indian J Cancer. 2015;52(1):605-10.






Original Research Articles