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Questions and Answers
What socio-economic status is commonly associated with a higher prevalence of Oral Cancer?
lower socio-economic groups
Which racial/ethnic group has higher rates of Oral Cancer than most other countries?
Poor oral hygiene and poor dentition have been implicated in few studies as risk factors for Oral Cancer.
True
Marijuana smoking has been reported to have an increased risk for head and neck cancer, but there is no consistent evidence. Any causal inference shown could be due to interaction with heavy ______ use.
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Match the following possible risk factors for malignant transformation of Oral Lichen Planus:
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What are some well-known and established risk factors for oral cancer?
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Which carcinogens are most important in tobacco smoke?
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Smoking cessation can produce beneficial results by reducing the prevalence of Oral Leukoplakia and the incidence of Oral Cancer.
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______ is a significant risk factor for Oral Leukoplakia, even among non-users of tobacco, especially in females.
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Match the following carcinogens with their effects:
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Study Notes
Oral Cancer Incidence
- In Sri Lanka, the incidence of lip, oral cavity, and pharynx cancer increased from 1617 in 2005 to 2422 in 2010 and 2199 in 2014, with a ranking of 2.
Premalignant Oral Lesions and Conditions (OPMDs)
- Examples of OPMDs include andExamples of Premalignant Oral Lesions and Conditions (OPMDs) include leukoplakia, a white patch on the mucous membrane that can progress to cancer. Erythroplakia is a red patch, often connected to smoking. Oral submucous fibrosis is a condition where the fibrous tissue in the mouth thickens, causing stiffness and pain. Additional conditions include lichen planus, a chronic inflammatory disease affecting the mouth and genitals, and discoid lupus erythematosus, a type of lupus that affects the skin and connective tissue. inherited disorders.
Risk Factors for OPMDs and Oral Cancer
- Established risk factors for oral cancer include:
- Tobacco (smoking, snuff, and smokeless tobacco)
- Betel quid chewing
- Alcohol misuse
- Sunlight exposure
- Radiation
- Human papillomavirus (HPV) infection
- Immune deficiency
- Socioeconomic status
- Ethnicity and race
- Possible risk factors for oral cancer include:
- Candidal infection
- Diet and nutrition
- Oral hygiene and dentition
- HIV infection
- Marijuana (cannabis) smoking
- Nicotine replacement therapy (NRT)
- Mouthwashes
- The risk factors for OPMDs are not as clear as those for oral cancer, but they are considered to be similar.
Tobacco and Oral Cancer
- All forms of smoking have equal excess risks for oral cancer.
- The most important carcinogens in tobacco smoke are:
- Aromatic hydrocarbon benzpyrene
- Tobacco-specific nitrosamines (TSNs)
- These carcinogens bind to DNA, causing critical mutations and leading to the development of oral cancer.
Alcohol and Oral Cancer
- There is no clear evidence that specific types of alcoholic drinks have different effects on oral cancer.
- The most prevalent alcoholic beverage in a population is the one with the highest risk in that population.
- Alcohol acts synergistically with tobacco to increase the risk of oral cancer development.
Betel Quid and Oral Cancer
- Betel quid chewing is a major risk factor for oral cancer.
- The ingredients in betel quid are genotoxic, cytotoxic, and stimulate cell proliferation.
- The risk of oral cancer increases with the duration and frequency of betel quid use.
Areca Nut and Oral Cancer
- Areca nut chewing is a risk factor for oral cancer, particularly in combination with tobacco products.
- The alkaloids in areca nut have been isolated and identified as arecoline, arecaidine, guracine, guacine, and arecolidine.
Oral Submucous Fibrosis (OSF) is a chronic inflammatory and proliferative disease of the submucous tissue in the oral cavity. It is characterized by the replacement of normal submucosa with fibrous scar tissue, leading to stiffness and rigidity of the mouth and tongue. The etiology of OSF is multifactorial and may be linked to the consumption of areca nut, a stimulant found in betel quid. Among people who chew betel quid, tobacco use may enhance the risk of OSF. In addition to its oral manifestations, OSF has been associated with numerous systemic diseases, including scleroderma, systemic lupus erythematosus, and polymyositis. Diagnosis of OSF is typically made by evaluating symptoms, conducting a physical examination, and using imaging studies, such as computed tomography (CT) or magnetic resonance imaging (MRI), to rule out other potential causes of mouth stiffness. Individuals with OSF are typically treated conservatively, with goals focused on alleviating symptoms and maintaining oral function.
- OSF is a multifactorial condition, with areca nut chewing being the main causative agent.
- Contributory risk factors for OSF include chewing of smokeless tobacco, high intake of chilies, toxic levels of copper in foodstuffs, vitamin deficiencies, and malnutrition.
Emerging Risk Factors
- Human papillomavirus (HPV) infection is a risk factor for oral cancer, particularly in the oropharynx.
- Candidal infection may be associated with oral cancer risk, but convincing data are lacking.
Controversial Factors
- Ethnicity and race may be associated with oral cancer risk, but the evidence is limited.
- Nutritional differences, smoking patterns, and differences in amounts smoked or alcohol used may play a role in oral cancer risk.
- Poor oral hygiene and dentition may be associated with oral cancer risk, but the evidence is limited.
Oral Lichen Planus (OLP) and Malignant Transformation
- OLP is a premalignant oral lesion, with a malignant transformation rate of 1.1%.
- The mechanism of malignant transformation is not clear, but tobacco smoking, alcohol use, and HPV infection may be risk factors.
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Description
This quiz covers the incidence of oral cancer, including statistics on lip, oral cavity, and pharynx cancer from 2005 to 2010. It also explores the etiology of oral cancer and OPMD. This quiz is suitable for dental students and professionals.
