Tobacco consumption practices and risk of oro-pharyngeal cancer: a case-control study in Central India

A hospital based, group matched case control study was conducted with the objective to assess the association between tobacco consumption practices and risk of development of oro-pharyngeal cancer in Central India. The study included 123 cases of oro-pharyngeal cancer, diagnosed on the basis of histopathology at three tertiary care centers in Nagpur city. Each case was matched for age and sex with two hospital controls: one selected from non-cancer patients and another from patients having cancer of other sites. Tobacco chewing (OR=7.98, 95% CI 4.11-13.58) and tobacco smoking (OR=2.25, 95% CI 1.22-3.70) were found to be significantly associated with oro-pharyngeal cancer on unconditional multiple logistic regression analysis. Further analysis revealed a dose-response relationship between increasing frequency, duration and retention time of tobacco in mouth and risk of oro-pharyngeal cancer. Other risk factors which were also found to contribute significantly in the outcome of oro-pharyngeal cancer in the study population were: use of traditional/local substances (eg pan, betel nut, lime) with or without tobacco, use of tobacco containing material for teeth cleaning, type of smoking (eg bidi, chillum, cigarette) and outdoor occupations. High values of estimates of attributable risk percent (ARP) and population attributable risk percent (PARP) confirmed the positive impact of reduction or elimination of the tobacco consumption practices on reducing the risk of oro-pharyngeal cancer in the population of Central India.