Buccal Mucosa Carcinoma: A Comparative Relative Risk Analysis between Tobacco and Non Tobacco Users

Abstract

Introduction: In South India, buccal mucosa carcinoma is common cancer due to widespread use of tobacco in different form. Recently, areca nut (non tobacco) chewing habits have increased among young adults resulting in high morbidity and mortality. Thus, there is need to understand role of aetiology and risk of disease. Aim: To analyse relative risk of tobacco users and non tobacco users in buccal mucosa carcinoma. Materials and Methods: This prospective comparative study was conducted in Regional Cancer Centre, Kanchipuram, between 2013 and 2016. The subjects were divided as tobacco users and non tobacco users in order to evaluate the Relative Risk (RR) in these groups based on demographic and clinical characteristics by Chi-square analysis and Kaplan-Meier (logrank test) applied for survival difference. All statistics considered at 95 % CI, p<0.05. Results: A total of 117 subjects were included in the study which constituted 87 (74.3%) tobacco users and 30 (25.7%) non tobacco users. In the study, demographic characteristics of gender [RR=0.365 (0.150-0.886), p=0.023] and age groups {RR=2.026 (0.905-4.996), p=0.04} showed significant difference in both study groups. Similarly, clinical characteristics of TNM (tumour node and metastasis) stage {RR=1.57 (0.338-3.31), p=0.024}, nodal status {RR=2.014 (0.412-4.454), p=0.017}, Grade of tumour {RR=1.293 (0.581-2.878), p=0.015}, perineural invasion {RR=2.601 (0.806-5.32), p=0.012} and extracapsular invasion {RR=1.627 (0.533-2.824), p=0.045} showed significant association. The estimated overall survival was 50%; tobacco users (44%) showed lower survival than non tobacco users (57%) with significant difference (p=0.042, p<0.05). Conclusion: The study revealed adverse affect of aetiology on survival and showed lower survival of tobacco users than non tobacco users. Hence, the study concluded that the tobacco consumption in different form is more aggressive than non tobacco consumption.

Keywords

• alcohol
• areca nut
• pan masala
• squamous cell carcinoma of buccal mucosa