Smokeless Tobacco Usage and Oral Cancer Risk: A Hospital-Based Case-Control Study From Bangladesh.

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Smokeless tobacco (SLT) use is prevalent in South Asia, with strong links to oral cancer.
• Limited evidence exists on the specific association between SLT use and oral cancer in Bangladesh.
• Understanding this link is crucial for public health interventions in the region.

Purpose of the Study:

• To investigate the association between smokeless tobacco (SLT) use and oral cancer among adults in Bangladesh.
• To estimate the population-level burden of oral cancer attributable to SLT use in Bangladesh.

Main Methods:

• A hospital-based case-control study conducted in Dhaka, Bangladesh, involving 169 oral cancer cases and 338 controls.
• Data collected through structured interviews on SLT use, smoking, alcohol consumption, BMI, and socio-demographics.
• Unconditional logistic regression used to estimate adjusted odds ratios (ORs) and population attributable fractions (PAFs).

Main Results:

• SLT use showed a strong association with oral cancer (adjusted OR: 8.78).
• Risk was significantly higher in women (OR: 14.33) and dual users of SLT and smoked tobacco (OR: 17.23).
• SLT use accounted for an estimated 41% of male and 76% of female oral cancer cases.

Conclusions:

• Smokeless tobacco (SLT) is a major, modifiable risk factor for oral cancer in Bangladesh, particularly impacting women and dual tobacco users.
• Findings underscore the necessity for enhanced regulation, gender-specific education, and targeted SLT control initiatives.
• Local evidence is vital for informing national and international oral cancer prevention policies.