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Oral cavity cancer risk in relation to tobacco chewing and bidi smoking among men in Karunagappally, Kerala, India: Karunagappally cohort study.

Abstract

The Karunagapally cohort in Kerala, India was established in the 1990s. The present study examined oral cancer risk among 66,277 men aged 30-84 years in the cohort, using Poisson regression analysis of grouped data, stratified on attained age, calendar time, education, and family income. By the end of 2005, 160 oral cancer cases were identified by the Karunagapally Cancer Registry. Tobacco chewing increased oral cancer risk (P < 0.001). Particularly increased was the risk of cancers of the gum and mouth (relative risk [RR] = 4.7; 95% confidence interval [CI] = 2.8-7.9), which increased with higher daily frequencies (P < 0.001) and longer duration (P < 0.001) of tobacco chewing. Alcohol drinking was not significantly related to oral cancer risk regardless of tobacco chewing. Bidi smoking significantly increased oral cancer risk (RR = 2.6; 95%CI = 1.4-4.9) only among men without tobacco chewing habits. The risk increased with higher daily consumption (P < 0.001), longer duration (P = 0.001), and younger age at start of bidi smoking (P = 0.007). In location-specific analysis, bidi smoking was significantly associated with cancer of the gum and mouth (RR = 3.6; 95%CI = 1.1-12.1), and its risk significantly increased with larger daily consumption of bidis (P = 0.013) and younger age at the start of smoking (P = 0.044). Tongue cancer risk was significantly increased among men who smoked bidis for 30 years or longer, and men started bidi smoking at 18 years old or younger. The present study is the first cohort study showing that tobacco chewing increases cancers of the gum and mouth among men keeping chewing tobacco in the cheek, and that bidi smoking strongly increased oral cancer risk among men without a tobacco chewing habit.

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  • Authors+Show Affiliations

    ,

    Regional Cancer Center, Trivandrum, Kerala, Japan.

    , , ,

    Source

    Cancer science 102:2 2011 Feb pg 460-7

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Cohort Studies
    Humans
    India
    Male
    Middle Aged
    Mouth Neoplasms
    Risk Factors
    Smoking
    Tobacco, Smokeless

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    21129124

    Citation

    Jayalekshmi, Padmavaty Amma, et al. "Oral Cavity Cancer Risk in Relation to Tobacco Chewing and Bidi Smoking Among Men in Karunagappally, Kerala, India: Karunagappally Cohort Study." Cancer Science, vol. 102, no. 2, 2011, pp. 460-7.
    Jayalekshmi PA, Gangadharan P, Akiba S, et al. Oral cavity cancer risk in relation to tobacco chewing and bidi smoking among men in Karunagappally, Kerala, India: Karunagappally cohort study. Cancer Sci. 2011;102(2):460-7.
    Jayalekshmi, P. A., Gangadharan, P., Akiba, S., Koriyama, C., & Nair, R. R. (2011). Oral cavity cancer risk in relation to tobacco chewing and bidi smoking among men in Karunagappally, Kerala, India: Karunagappally cohort study. Cancer Science, 102(2), pp. 460-7. doi:10.1111/j.1349-7006.2010.01785.x.
    Jayalekshmi PA, et al. Oral Cavity Cancer Risk in Relation to Tobacco Chewing and Bidi Smoking Among Men in Karunagappally, Kerala, India: Karunagappally Cohort Study. Cancer Sci. 2011;102(2):460-7. PubMed PMID: 21129124.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Oral cavity cancer risk in relation to tobacco chewing and bidi smoking among men in Karunagappally, Kerala, India: Karunagappally cohort study. AU - Jayalekshmi,Padmavaty Amma, AU - Gangadharan,Paleth, AU - Akiba,Suminori, AU - Koriyama,Chihaya, AU - Nair,Raghu Ram K, Y1 - 2010/12/06/ PY - 2010/12/7/entrez PY - 2010/12/7/pubmed PY - 2011/3/12/medline SP - 460 EP - 7 JF - Cancer science JO - Cancer Sci. VL - 102 IS - 2 N2 - The Karunagapally cohort in Kerala, India was established in the 1990s. The present study examined oral cancer risk among 66,277 men aged 30-84 years in the cohort, using Poisson regression analysis of grouped data, stratified on attained age, calendar time, education, and family income. By the end of 2005, 160 oral cancer cases were identified by the Karunagapally Cancer Registry. Tobacco chewing increased oral cancer risk (P < 0.001). Particularly increased was the risk of cancers of the gum and mouth (relative risk [RR] = 4.7; 95% confidence interval [CI] = 2.8-7.9), which increased with higher daily frequencies (P < 0.001) and longer duration (P < 0.001) of tobacco chewing. Alcohol drinking was not significantly related to oral cancer risk regardless of tobacco chewing. Bidi smoking significantly increased oral cancer risk (RR = 2.6; 95%CI = 1.4-4.9) only among men without tobacco chewing habits. The risk increased with higher daily consumption (P < 0.001), longer duration (P = 0.001), and younger age at start of bidi smoking (P = 0.007). In location-specific analysis, bidi smoking was significantly associated with cancer of the gum and mouth (RR = 3.6; 95%CI = 1.1-12.1), and its risk significantly increased with larger daily consumption of bidis (P = 0.013) and younger age at the start of smoking (P = 0.044). Tongue cancer risk was significantly increased among men who smoked bidis for 30 years or longer, and men started bidi smoking at 18 years old or younger. The present study is the first cohort study showing that tobacco chewing increases cancers of the gum and mouth among men keeping chewing tobacco in the cheek, and that bidi smoking strongly increased oral cancer risk among men without a tobacco chewing habit. SN - 1349-7006 UR - https://www.unboundmedicine.com/medline/citation/21129124/Oral_cavity_cancer_risk_in_relation_to_tobacco_chewing_and_bidi_smoking_among_men_in_Karunagappally_Kerala_India:_Karunagappally_cohort_study_ L2 - https://doi.org/10.1111/j.1349-7006.2010.01785.x DB - PRIME DP - Unbound Medicine ER -