Risk markers of oral cancer in clinically normal mucosa as an aid in smoking cessation counseling.
Quitting smoking may prevent oral cancer. Behavioral intervention to quit smoking may be more efficient if persons are assigned an individual risk of cancer.



In this prospective study, we provided counseling and behavioral intervention toward smoking cessation, supplemented by genetic analyses in clinically normal oral mucosa of heavy smokers. Measurement of serum cotinine was used to assess changes in smoking habits.



In cytologic scrapings from 275 heavy smokers with clinically normal mucosa, we found tetraploidy in four and aneuploidy in 19 persons (23 of 275; 8%). Twenty one (91%) of 23 persons with aneuploidy had quit or reduced their smoking habits at the 3-month follow-up, 20 (87%) of 23 persons had done so at 12 months, and 21 (91%) of 23 persons had done so at 24 months. Fifty-one (20%) of the 252 persons without genetic changes in their mucosa had quit or reduced their tobacco habits at the 3-month follow-up, 23 (9%) had done so at 12 months, and 17 (7%) had done so at 24 months (P < .001). After 24 months, normalization of DNA content to diploidy was observed in two of four persons with tetraploid (50%), and in 11 of 19 persons (58%) with aneuploid scrapings. One patient developed an oral carcinoma in the floor of the mouth: this patient had an aneuploid scraping obtained 43 months earlier and developed a leukoplakia 28 months before the carcinoma.



Risk markers of oral cancer are present in clinically normal mucosa of heavy smokers, and such findings enhance the adherence to smoking cessation on counseling. Cytogenetic aberrations may normalize after quitting smoking.
Sudbø
Jon
J
DDS, Department of Medical Oncology and Radiotherapy, The Norwegian Radium Hospital, Ullernchausseen 70, Montebello, 0310 Oslo, Norway. jon.sudbo@rh.uio.no
Samuelsson
Roy
R
Risberg
Björn
B
Heistein
Stig
S
Nyhus
Christian
C
Samuelsson
Margaretha
M
Puntervold
Ruth
R
Sigstad
Eva
E
Davidson
Ben
B
Reith
Albrecht
A
Berner
Asmund
A
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D014408:Biomarkers, Tumor; D003376:Counseling; D020732:Cytogenetic Analysis; D005260:Female; D006801:Humans; D007972:Leukoplakia, Oral / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000209:etiology* / Q000235:genetics / Q000517:prevention & control; D011003:Ploidies; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D000074606:Smoking Prevention
D014408:Biomarkers, Tumor