title: Alcohol drinking, body mass index and the risk of oral leukoplakia in an Indian population.
abstract: Although tobacco habits have been associated with the risk of oral leukoplakia, alcohol drinking and body mass index (BMI) as risk factors have not been well established. The purpose of this study is to evaluate the independent effects of drinking, BMI, tobacco chewing and smoking on the risk of oral leukoplakia. A case-control study was conducted, with data from an ongoing randomized oral cancer screening trial in Kerala, India. Trained health workers conducted interviews and performed oral visual inspections to identify oral premalignant lesions such as leukoplakia. The logistic regression model in SAS was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). A total of 927 leukoplakia cases and 47,773 controls were included in the analysis. Ever alcohol drinking was a significant risk factor for oral leukoplakia among nonsmokers (OR=2.1, 95%CI=1.3, 3.4) and non-chewers (OR=1.8, 95%CI=1. 3, 2.5) after adjusting for age, sex, education, BMI and tobacco habits. The association with alcohol drinking was stronger among women (OR=3.9, 95%CI=1.5, 10.4) than men (OR=1.5, 95%CI=1.3, 1.9). An inverse dose-response relationship was observed between BMI and the risk of oral leukoplakia (p for trend=0.0075). Tobacco chewing was a stronger risk factor for women (OR=37.7, 95%CI=24.2, 58.7) than for men (OR=3.4, 95%CI=2.8, 4.1). Smoking was a slightly stronger risk factor for men (OR=3.3, 95%CI=2.5, 4.3) than for women (OR=2.0, 95%CI=1.5, 2.9). In conclusion, alcohol drinking was found to be an independent risk factor while BMI might be inversely associated with the risk of oral leukoplakia in an Indian population.
authors.affiliation: Department of Epidemiology, UCLA School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California 90095-1772, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hashibe
authors.forename: R
authors.initials: R
authors.lastname: Sankaranarayanan
authors.forename: G
authors.initials: G
authors.lastname: Thomas
authors.forename: B
authors.initials: B
authors.lastname: Kuruvilla
authors.forename: B
authors.initials: B
authors.lastname: Mathew
authors.forename: T
authors.initials: T
authors.lastname: Somanathan
authors.forename: D M
authors.initials: DM
authors.lastname: Parkin
authors.forename: Z F
authors.initials: ZF
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007972:Leukoplakia, Oral / Q000453:epidemiology* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010947:Plants, Toxic; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D014030:Tobacco, Smokeless / Q000009:adverse effects