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      Assessment of knowledge and awareness among North Indian populations about oral precancerous lesions (OPL): A cross-sectional survey study

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          Abstract

          Background:

          A precancerous lesion is a morphologically altered tissue in which oral cancer is more likely to occur than its apparently normal counterpart. They are quite common in the Indian population due to the habitual habit of chewing tobacco. The aim of this study was to evaluate the awareness of oral precancerous lesions by a questionnaire-based survey among the study subjects having been diagnosed with it.

          Methods:

          In this descriptive study, a structured questionnaire having 11 survey questions has been used to record the response from study subjects who have been diagnosed and reported for treatment for oral premalignant lesions in the Department of Oral Medicine and Radiology. A total of 1013 study subjects were assessed for awareness about OPL and its consequences.

          Results:

          44.3% of the study population was addicted to smoking tobacco (cigarettes) while 57.9% of study subjects were addicted to non-smoking tobacco (Pan masala). The reason behind their addiction was reported to be stress (54.9%) and workload (25.3%). Most of the study subjects were diagnosed with oral sub-mucous fibrosis (53.4%). 78.6% of study subjects diagnosed with OPL were not aware of it and 94% were willing to quit the addiction.

          Conclusion:

          The awareness about OPL among patients was found to be low. Although many wanted to quit their addiction to smoking and chewing tobacco but were unable to do so. So it is a need for time to develop a national policy on tobacco use and related diseases. This policy will definitely reduce the burden of oral premalignant lesions and oral cancer in Indian population.

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          Most cited references25

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          Global epidemiology of oral and oropharyngeal cancer.

          This review presents data on incidence, mortality, survival and trends in cancers of the lip, oral cavity and oropharynx using available recent data sources around the world. Oral and pharyngeal cancer, grouped together, is the sixth most common cancer in the world. The review focuses primarily on several high-risk countries in an attempt to gain insight into the geographic variations in the incidence of this cancer in the globe and to relate the high incidence in some populations to their life style. With an estimated half a million cases around the globe and the rising trends reported in some populations, particularly in the young, urgent public health measures are needed to reduce the incidence and mortality of oral and oropharyngeal cancer.
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            Survival following primary surgery for oral cancer.

            The main aims of this article are to report the overall and disease-specific survival of a consecutive series of patients presenting with oral cancer from 1992 to 2002 and to relate survival to clinical and pathological factors. The article uses population-based age-sex mortality rates in the North-West of England to highlight differences in overall and disease-specific survival. 541 patients with oral squamous cell carcinoma presented to the Regional Maxillofacial Unit from 1992 to 2002. Curative treatment favoured radical primary surgery, 10% (52) received primary radiotherapy. These patients were on average 8 years older with more advanced tumours and overall poorer survival at 5 years, 23% (SE 7%). The remainder of the results refer to 489 patients who had primary curative surgery, 40% (194) of whom received adjuvant radiotherapy. The overall survival (OS) was 56% (SE 2%) and the disease-specific survival (DSS) was 74% (SE 2%). There was a local recurrence rate of 10% (50) and the loco-regional recurrence rate was 21% (103). The second primary rate was 7% (35). Survival figures had improved over the 10-year period from 63% DSS for the first 4 years of the study (1992-1995) compared to 81% for the last 3 years (2000-2002). In stepwise Cox regression the two predictors selected for disease-specific survival were pN status and margins (both p<0.001). Age-sex mortality rates for the North-West indicate that 15.0% of the 489 primary surgery patients might have been expected to die within 5 years if they were typical of the general population and the observed difference between all causes and oral-cancer specific survival was 18.3%. These data emphasise the value of disease-specific survival as an indicator of successful treatment in a cohort that tends to be elderly, from social deprived backgrounds, with life styles and comorbidity that influence overall survival.
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              Oral cancer in India: an epidemiologic and clinical review.

              This article reviews the epidemiologic and clinical aspects of oral cancer in India, where the disease ranks number one among all cancers in male patients and number three among cancers in female patients. Causal association between oral cancer and the chewing of betel quids containing tobacco leaves or stem and other tobacco habits has been extensively studied. But there is need for more in-depth studies on the role of alcohol, diet, and oral hygiene practices in India. The exciting opportunity provided by the well-established oral precancerous lesions for intervention and early detection programs is also discussed. The peak age frequency of occurrence is at least a decade earlier than that described in Western literature. Sex ratio reveals a 2:1 preponderance of male patients. Only 10% to 15% of cases present in localized stages. The poor survival revealed by existing studies is mainly due to the overwhelming proportion of advanced cases. The excellent opportunity for more research and efforts in prevention and control of oral cancer in India is highlighted in this review.
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                Author and article information

                Journal
                Natl J Maxillofac Surg
                Natl J Maxillofac Surg
                NJMS
                Natl J Maxillofac Surg
                National Journal of Maxillofacial Surgery
                Wolters Kluwer - Medknow (India )
                0975-5950
                2229-3418
                Sep-Dec 2023
                10 November 2023
                : 14
                : 3
                : 454-459
                Affiliations
                [1]Department of Conservative Dentistry and Endodontics, King George Medical University, Lucknow, Uttar Pradesh, India
                [1 ]Department of Radiotherapy, King George Medical University, Lucknow, Uttar Pradesh, India
                [2 ]Department of Oral Medicine and Radiology, King George Medical University, Lucknow, Uttar Pradesh, India
                [3 ]Department of Oral and Maxillofacial Surgery Unit, Faculty of Dental Sciences, IMS BHU, Varanasi, Uttar Pradesh, India
                Author notes
                Address for correspondence: Dr. Akhilanand Chaurasia, Department of Oral Medicine and Radiology, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India. E-mail: chaurasiaakhilanand49@ 123456gmail.com
                Article
                NJMS-14-454
                10.4103/njms.njms_150_22
                10806308
                0c6c98de-aa4d-4d93-ab75-cb6a273dd3c2
                Copyright: © 2023 National Journal of Maxillofacial Surgery

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 30 August 2022
                : 05 January 2023
                : 10 January 2023
                Categories
                Original Article

                Surgery
                awareness,oral premalignant lesions,oral sub-mucous fibrosis
                Surgery
                awareness, oral premalignant lesions, oral sub-mucous fibrosis

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