Prevalence of Potentially Malignant Oral Mucosal Lesions among Tobacco Users in Jeddah, Saudi Arabia

Abstract

Smoking is recognized as a health problem worldwide and there is an established tobacco epidemic in Saudi Arabia as in many other countries, with tobacco users at increased risk of developing many diseases. This cross sectional study was conducted to assess the prevalence of oral mucosal, potentially malignant or malignant, lesions associated with tobacco use among a stratified cluster sample of adults in Jeddah, Saudi Arabia. A sample size of 599 was collected and each participant underwent clinical conventional oral examination and filled a questionnaire providing information on demographics, tobacco use and other relevant habits. The most common form of tobacco used was cigarette smoking (65.6 %) followed by Shisha or Moasel (38.1%), while chewing tobacco, betel nuts and gat accounted for 21-2%, 7.7%, and 5% respectively. A high prevalence (88.8%) of soft tissue lesions was found among the tobacco users examined, and a wide range of lesions were detected, about 50% having hairy tongue, 36% smoker's melanosis, 28.9% stomatitis nicotina, 27% frictional keratosis, 26.7% fissured tongue, 26% gingival or periodontal inflammation and finally 20% leukodema. Suspicious potentially malignant lesions affected 10.5% of the subjects, most prevalent being keratosis (6.3%), leukoplakia (2.3%), erythroplakia (0.7%), oral submucous fibrosis (0.5%) and lichenoid lesions (0.4%), these being associated with male gender, lower level of education, presence of diabetes and a chewing tobacco habit. It is concluded that smoking was associated with a wide range of oral mucosal lesions , those suspicious for malignancy being linked with chewable forms, indicating serious effects.

Effectiveness of an Intervention Program on Knowledge of Oral Cancer among the Youth of Jazan, Saudi Arabia

“…The lack of knowledge regarding self examination of the lesions was also observed among the youth which can be critical at times. Self-examination is currently considered as one of the forms of early detection of a pre malignant lesion and any type of lumps, sores and lesions (red/white) seen in the mouth should not be ignored (Mathew et al, 1995;Elango et al, 2011;Al-Attas et al, 2014). The post intervention results showed a significant improvement in the knowledge of the respondents as the mean value obtained was fairly high.…”

Smokeless Tobacco (Shammah) in Saudi Arabia: A Review of its Pattern of Use, Prevalence, and Potential Role in Oral Cancer

“…Samples of such study underwent clinical conventional oral examination and filled a questionnaire providing information on demographics, tobacco use and other relevant habits. The most common form of tobacco used was cigarette smoking followed by Shisha, ST, betel nuts and Khat, respectively (Al-Attas et al, 2014). They concluded that ST was associated with a wide range of oral mucosal lesions (Al-Attas et al, 2014).…”

“…The most common form of tobacco used was cigarette smoking followed by Shisha, ST, betel nuts and Khat, respectively (Al-Attas et al, 2014). They concluded that ST was associated with a wide range of oral mucosal lesions (Al-Attas et al, 2014).…”

Tobacco (Kretek) Smoking, Betel Quid Chewing and Risk of Oral Cancer in a Selected Jakarta Population

“…Moreover, findings from a nationally representative sample in India which have among the highest prevalence of oral cancer in the world showed that tobacco-related cancers accounted for 42% and 18.3% of male and female deaths respectively, where there were twice as many deaths among oral cancer as compared to lung cancer . A recent study noted that the prevalence of oral potentially malignant lesions among smokers is 10.5% (Al-Attas et al, 2014), while 61.8% of patients who smoked tobacco were found to have clinically detectable oral mucosa changes (Sujatha et al, 2012). A dose-response relationship was also evident where smoking for a longer duration and frequency were found to confer an increased risk for malignant lesions (Loyha et al, 2012).…”

“…It is a widely practiced risk habit in Asian countries such as Pakistan, India, Sri Lanka, Bangladesh, and Taiwan where numerous studies have reported a dose-response relationship of increased oral cancer risk with the practice of this habit (Balaram et al, 2002;Muwonge et al, 2008;Amarasinghe et al, 2010;Lin, 2011;Loyha et al, 2012). A recent study among tobacco users found that tobacco chewers had a 13-fold increased risk for development of oral lesions (Al-Attas et al, 2014). Although variations can be seen in the content of a betel quid across the different countries, a typical quid would contain areca nut, slaked lime and flavouring ingredients which are wrapped in betel leaf.…”