title: Smokeless tobacco (shamma) and oral cancer in Saudi Arabia.
abstract: Oral use of smokeless tobacco has been associated with the development of oral cancer. Shamma is a preparation of smokeless tobacco. Previous investigators in the Kingdom of Saudi Arabia (KSA) have reported a relationship between their patients with oral cancer and a history of using shamma. The purpose of this study was to explore the possible relationship between a smokeless tobacco preparation (shamma) and oral cancer, among the provinces of the KSA. Tumor Registry (TR) data from the King Faisal Specialist Hospital and Research Centre (KFSH&RC) were reviewed for the period from 1976 to 1995. A total of 26510 Saudi cancer patients were referred over this 20-year period. The frequency of oral cancer was investigated, specifically for those primary sites located near the habitual placement of this smokeless tobacco product. Notably, 35.4% of these oral cancers were referred from one province - Jizan. The percentage of oral cancer cases from this province is significantly higher than the percentage of total malignant cases referred to KFSH&RC from this province, and the Saudi population of this province when compared to the whole of the KSA. These data suggest that there is a relationship between the factors smokeless tobacco product (shamma), frequency of oral cancer, and Jizan province: oral cancer appears to be more common in this province where shamma is also common.
authors.affiliation: Department of Dentistry, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
authors.forename: W F
authors.initials: WF
authors.lastname: Allard
authors.forename: E B
authors.initials: EB
authors.lastname: DeVol
authors.forename: O B
authors.initials: OB
authors.lastname: Te
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor; D009061:Mouth Mucosa; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D010947:Plants, Toxic; D015995:Prevalence; D012111:Residence Characteristics; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D012744:Sex Ratio; D013223:Statistics as Topic / Q000379:methods; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D014062:Tongue Neoplasms / Q000453:epidemiology / Q000209:etiology