Characterisation of Clinicopathological and Molecular Features of Leukoplakia not Associated with Tobacco- A Literature Review

Abstract

Tobacco has been implicated as the strongest risk factor for oral malignancies and common potentially malignant disorders. Recent trend shows an increase in the prevalence of these lesions in non tobacco population. Studies suggest that clinicopathological features of leukoplakia differ in tobacco users and non users. Also, leukoplakia without known risk factors is at a higher risk of malignant transformation. Preliminary studies on carcinogenesis of non tobacco-associated head and neck cancers have identified a difference in the key genes involved in the pathogenesis of cancers associated with and without tobacco. While the genetic characterization of non tobacco oral cancers is gaining focus in the literature, there is a paucity of studies on non tobacco leukoplakia. An understanding of the non tobacco leukoplakia, possibly a distinct subgroup, may provide an insight into the inception of non tobacco oral cancers, leading to avenues for prevention, early diagnosis and precision medicine-led treatment approaches. Through this narrative review, authors revisit and summarize the existing literature on leukoplakia among non tobacco population.