oral cancer
DESCRIPTION
oral cancerTRANSCRIPT
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M.Aqeel Maqsood
Roll# 146
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Epidemiology , Etiology and Prevention of Oral cancer
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What is Cancer?
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Defined as:_
• An uncontrolled, uncoordinated, excessive and abnormal growth of cells is called cancer.
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Benign Vs. Malignant
• Does not spread• Rarely life threatening• Can be removed
• Spreads to other parts of the body
• Life threatening• Can be removed, but
it may grow back
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Types of Cancer
• Benign• Malignant
–Carcinoma• epithelial origin• E.g. squamous cell carcinoma
–Sarcoma• Mesenchymal origin
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Oral cancer
• Defined as:_Indurated, ulcerated lump or sore that may or may not be painful and is often associated cervical lymph adenopathy.
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Tongue34%
Retromolar 2%Ginggiva Max
12%Ginggiva Mand
7%
Buccal24%
Lower Lip16%
Palatum5%
Distribution of Oral Cancer According to Locations
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Why is it such an important public health issue?
• Closely associated with tobacco and alcohol.• 2nd most common cause of death• In 2003-according to world health report 7.1
million deaths were reported.• Estimated 50% increase in death rate in next 20
years.• In Bangladesh, Sirilanka and Pakistan most
common type of cancer.• And 1/3rd of all the cancers.
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Signs and Symptoms
• Sores that do not heal within 14 days
• Bleeding in mouth • Lump in neck• Earache• Loose teeth• Dentures will not fit
well
• Pain or numbness in mouth
• Difficulty chewing or swallowing
• Bad breath• Patches on the lip or
in the mouth that are red, white, or a mixture of both
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Epidemiology of oral cancer
Agent
Environment
Host
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Host factors
1. Age – Incidence increases with age.– 98% cases in the west are over 40yrs old.– More than 50% of cases include ages above 50yrs.
2. Gender– Incidence is more in
• Men• Industrial areas
– Women have more incidence of lip carcinoma– Men have high incidence of buccal carcinoma
3. Occupation– Textile workers and leather industries have high incidence of
buccal cavity and larynx carcinoma.
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Host Factors
4. Immunity– AIDS patients are prone to Kaposi carcinoma.
5. Social Class
6. Custom and habits
7. Race
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Agent Factors
• Biological– HIV– Candida
• Chemical– Arsenic,dyes,nickel,chromium
• Mechanical– Ill fitting dentures– Sores from jagged teeth
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Agent factors
• Nutritional– Precarcinogens in food– Increase consumption of fat– Deficiency in folic acid– Deficiency of proteins– Increase in red chili
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Environmental factors
• Water contamination• Air pollution• Geographic variation
– Netherland buccal mucosa– Switzerland lip and tongue– Canadian Eskimos salivary glands
• Solar heat– Prolonged exposure causes melanoma
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Etiology
• Due to – Tobacco– Unhealthy diet– Alcohol– Physical inactivity – Infection– Nutrients– Physical irritants
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04/11/2023 Oral Cancer 19
Risk Factors
• Tobacco is the main culprit– Mainly chewing tobacco
– 75% of those diagnosed are tobacco users.• Alcohol 2nd largest risk factor• Combination of alcohol and tobacco use
– 15x greater risk for oral cancer• Excessive sun exposure
– Lip cancer
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04/11/2023 Oral Cancer 20
Risk Factors
• X-rays– Cumulative exposure
• Other biological factors– Viruses and fungus– HPV 16
• Main agent in cervical cancer• Now has been linked to oral cancer
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Tobacco
• Its an important risk factor of oral cancer.• 90% of cancers are caused by tobacco• Tobacco can be broadly classified into smokeless
and smoking forms.
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Smoking forms
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Bidi• Most popular
form of tobacco
• Estimated nictinic content is 1.7-3mg
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Cigar• Cured
tobacco wrapped in dried tobacco leaves.
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Chilum• Conical clay pipe
for smoking tobacco
• Filed with coarsely cut tobacco pieces
• Glowing charcoal is kept on top of tobacco
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Hookah• Indinan
origin• Also
known as water pipe.
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Cigerrete• 1gram tobacco
cured by sunlight is coverred by paper.
• 1-1.4mg Nicotinic content.
• More common in urban areas
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Smokeless forms
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Paan• Most common
habit of smokeles tobacco.
• May also include• Cardamom• Cocnut• Clove• Sugar• Tobacco wraped in
beetle leave
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Snuff• Finely
powdered air cured and fire cured tobacco leaves.
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Mishri• Prepared by
roasting tobacco on hot metal plate then powdered
• Also used to clean the teeth
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Khaini• Powdered
sundried tobacco.
• Simply placed in mouth and chewed
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Mainpuri Tobacco• Ingredients
include• Tobacco• Slaked lime• Camphor• cloves
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Prevention
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primary
secondary
tertiary
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Primary
Program to educate
adolescence
Program for tobacco users
Regular check up
good oral hygiene
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Secondary
Screening
Early detection
Referral
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Tertiary
• Surgery• Chemotherapy
– Cytotoxic drugs• Radiotherapy
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What you can do:
• Make yourself aware or your mouth• Stop smoking and drinking excessively• Be informed• Have a good diet and stay healthy• Behavioural modification
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Prevention as a dentist
• Regular check up• Suspected patients be thoroughly checked• Patient should be educated about the preventive
aspects of oral cancers including– Behavioral– Physical– community
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Any Question
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