Abstract
Background:
Oral cancer is the third most common cancer and a major health issue in Bangladesh. This study aimed to see the prevalence rate, age, site of involvement, gender and its relation with habits, histopathological grading, staging of diseases, and lymph node status.
Material and Methods:
Biopsy-proven oral cancer patients registered in the Oral and Maxillofacial Surgery unit of Anwer Khan Modern Medical College and Hospital, Dhaka, Bangladesh, affiliated with the University of Dhaka under the Faculty of Medicine. Patients included in this study were all surgically treated during 2017 to 2021. A total of 103 patients were included for this retrospective analysis.
Result:
The median age was 60.5 years (range: 31–90 years) with a mean [± standard deviation (SD)] of (58.88 ± 11.35) years [95% confidence interval (CI): 61.10–56.67], where 55.3% were male and 44.7% were female; the maximum involved site was lower gingiva-buccal sulcus extending to retro molar trigone, 34%. The maximum number of patients were betel quid chewer (betel leaf, areca nut mixed, chewing tobacco with slaked lime), that is, 61.2%.
Conclusion:
Most of the patients presented with stage IV disease (56.3%). This study aimed to see prevalence of oral cancer patients in a tertiary hospital.
Keywords: Betel quid, prevalence, lymph node, squamous cell carcinoma, tobacco
INTRODUCTION
Oral and pharyngeal cancer is the sixth most common cancer in the world.[1] Oral cancer is a major health problem in developing countries. The worldwide annual incidence rate of new cases exceeds 275,000.[2] Oral cancer is the carcinoma of the stratified squamous epithelium; about 96% of cases of oral cancer are squamous cell carcinoma.[3] With respect to head and neck cancer statistics, it has been reported that 30% of all malignancies in Southeast Asia are those of the head and neck region, whereas in Bangladesh, it is reported to be 20%.[4] Oral cavity cancer includes tumors of the buccal mucosa, retro molar trigone, alveolus, hard palate, anterior two-third of the tongue, floor of the mouth, and mucosal surface of the lip.[5] Incidence is higher in males than in females in most countries as they smoke and tobacco usage is combined at a higher rate. The ratio of males to females is about 1.5:1 for oral cavity cancer globally. About 90% of the oral SCC (squamous cell carcinoma) in Southeast Asia is attributable to tobacco use in its different forms, and in Bangladesh, it is the main etiological factor.[6] The buccal mucosa is the most common site to develop oral cancer in the Asian population due to betel-quid/tobacco chewing habits, whereas the tongue is the most common site among European and United States (US) populations.[7]
Many risk factors are directly or indirectly associated with the development of oral cancer. The most common are the betel quid chewer (betel leaf, areca nut, chewing tobacco mixed with slaked lime) and alcohol consumption; others are radiation, iron deficiency, vitamin A deficiency, oncogenic viruses such as human papilloma virus (HPV), and genetic predisposition.[8]
MATERIAL AND METHODS
This retrospective descriptive study was conducted from July 2017 to December 2021 in the Department of Dental and Maxillofacial Surgery. All the patients with oral cancer confirmed by histopathological examination were included in this study. Prior approval was taken from the Institutional Review Board (IRB) of AKMMC (University of Dhaka) to proceed with this retrospective study before collecting data.
Histopathologically proven oral cancers of different sub-types involving different sites of oral cavity (C00-C14) by the tenth revision of International statistical classification of diseases (ICD) were included in the study.[9]
Detailed information regarding the patient’s demographic status, clinical presentation, histopathological sub-types, tumor grading and stage of diseases, diagnosis, and lymph node status was retrieved from the hospital records. Stages were assigned according to the 8th edition published by the American Joint Committee on Cancer (AJCC), published in 2017 and corrected in 2018.[10]
Data were collected using a pre-tested data collection sheet. Clinical history, physical findings, histopathological findings, and treatment history were recorded in the prescribed questionnaire.
Initial pre-treatment work-up of the patients consisted of detailed clinical examination done in the out-patient department of Oral and Maxillofacial Surgery. Each patient was subjected to routine hematological and radiological investigations for planning the treatment. Computed tomography (CT) and/or magnetic resonance imaging (MRI) scan of the oral cavity and neck area were done to see the primary involvement and lymph node status.
All the collected data were entered into the computer database organized and analyzed using Statistical Package for the Social Sciences (SPSS) software version 29. Categorical data were presented as frequency and percentage, and the continuous variables were expressed as mean and standard deviation.
Data availability statement
The research data used to support the findings of this study are included within the article.
Ethical committee clearance obtained from AKMMC, DB (Institutional Ethics Review Board) dated: 10 Mar 24.
