Individual and Integrated Effects of Potential Risk Factors for Oral Squamous Cell Carcinoma: A Hospital-Based Case- Control Study in Jazan, Saudi Arabia

Abstract

Background: Oral cancer is the sixth most common cancer in the world, with a high prevalence reported in Jazan<br />province of Saudi Arabia. The objectives of this study were to check individual and integrated effects of potential risk<br />factors for oral squamous cell carcinoma. Materials and methods: A case control study was designed with a sample<br />of 210 subjects, in which histopathologically confirmed incident cases (n=70) and controls (n=140) matched for age,<br />gender and referral route, were recruited. Differences in exposure to potential risk factors between cases and controls<br />were assessed using chi-square and McNemar analyses. A logistic regression model with interactions was applied to check<br />individual and integrated effects. Results: Mean age of the sample was 55 years (+ 20 years). Shammah (O.R = 33.01;<br />C.I = 3.22 – 39.88), shisha (O.R = 3.96; C.I = 0.24 – 63.38), and cigarette (O.R = 1.58; C.I = 0.13, 2.50) consumption<br />was significantly associated (P<0.05) with oral squamous cell carcinoma development. In contrast, Khat chewing (O.R<br />= 0.67; C.I = 0.19-2.36) was without significant effect. An increase in odds ratios was observed when combinations<br />of shammah and shisha (O.R = 35.03; C.I = 11.50-65.66), shisha and cigarettes (O.R = 10.52; C.I = 1.03 – 33.90) or<br />shamma and cigarettes (O.R = 10.10; C.I = 0.50 - 20.40) were used. Conclusion: Combined exposure to risk-factors<br />has serious implications and policies on oral cancer prevention should be designed with attention to this aspect.