Correlation of degree of dysplasia in potentially malignant disorders with tobacco use: A cross-sectional study

Background: Oropharyngeal malignancies are the sixth leading cause of cancer worldwide. However, in India, oral and pharyngeal cancers are the most common cancer among men. It has been well established that virtually all oral cancer are preceded by a visible oral precursor lesions. Furthermore, the incidence of oral malignancies is higher among persons who use tobacco. We aimed to study the association between the degree of dysplasia in potentially malignant disorders (PMDs) with the type and duration of tobacco use. Materials and Methods: A record based cross-sectional study was conducted during February 2015. We included all the PMDs diagnosed and biopsied in our institute between 2006 and 2013. The study variables such as sex, age, type, and duration of tobacco habit were retrieved from the registers maintained in the Department of Oral Medicine and Radiology, and the histopathological diagnosis was retrieved from the biopsy reports of the PMDs documented in the Department of Oral Pathology. Lesions were classified as high-risk lesions (HRLs) or low-risk lesions (LRLs) based on the grade of cellular atypia and architectural features. The data were analyzed using EpiData software. Results: Out of total 112 cases, 80 (71%) were males and majority were older than 45 years (58%). About 64 (57%) reported use of any form of tobacco product. Of the tobacco users, 39 (65%) patients had reported tobacco use for 10 or more years. About one-fifth had HRL, and the remaining had LRL. Increasing age, any form of tobacco use (chewable or smoke form), tobacco smoking and longer duration of tobacco use were significantly associated with the development of HRLs (P < 0.05). Conclusion: By this retrospective study, we concluded that HRLs were more common among people who use any form of tobacco, either chewable or smoke form. Clearly, there is an increasing proportion of HRL with advancement in age and the duration of tobacco use.