title: Risk factors for leukoplakia and malignant transformation to oral carcinoma: a leukoplakia cohort in Taiwan.
abstract: The effects of betel nut chewing, smoking and alcohol on the occurrence of leukoplakia and its malignant transformation to oral carcinoma were quantified in a leukoplakia cohort (n = 435) from one medical centre between 1988 and 1998 in Taiwan. Sixty oral carcinomas were ascertained in this cohort. A case-control study within the leukoplakia cohort was used to study, risk factors. Using the Weibull survival model, the incidence of malignant transformation of leukoplakia was shown to increase with follow-up years. After adjustment for other relevant risk factors, betel nut chewing (adjusted odds ratio (OR) = 4.59; 95% confidence interval (CI) 1.25-16.86) remained a significant risk factor for malignant transformation. Results from the case-control study showed that the adjusted odds ratios for betel nut chewing and smoking on the occurrence of leukoplakia were 17.43 (95% CI 1.94-156.27) and 3.22 (95% CI 1.06-9.78), respectively. Similar findings were observed when daily frequency and duration were taken into account. This implies that cessation of smoking may reduce by 36% leukoplakia cases, while elimination of betel nuts may prevent 62% of leukoplakia and 26% of malignant transformation to oral carcinoma in the underlying population.
authors.affiliation: Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei.
authors.forename: M N
authors.initials: MN
authors.lastname: Shiu
authors.forename: T H
authors.initials: TH
authors.lastname: Chen
authors.forename: S H
authors.initials: SH
authors.lastname: Chang
authors.forename: L J
authors.initials: LJ
authors.lastname: Hahn
mesh_terms: D000428:Alcohol Drinking; D001114:Areca; D016022:Case-Control Studies; D002471:Cell Transformation, Neoplastic; D015331:Cohort Studies; D006801:Humans; D007972:Leukoplakia, Oral / Q000453:epidemiology* / Q000473:pathology; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000473:pathology; D010946:Plants, Medicinal; D012307:Risk Factors; D012907:Smoking; D013624:Taiwan