title: Oral precancerous disorders associated with areca quid chewing, smoking, and alcohol drinking in southern Taiwan.
abstract: OBJECTIVE
  To investigate the prevalence and the associated risk factors of oral precancerous disorders in southern Taiwan.
  
  
  METHODS
  We conducted a cross-sectional community survey interviewing 1075 adult subjects, 15 years of age and over, gathered from randomly selected 591 households, and spanning five villages in southern Taiwan. The study protocol included a visual oral soft tissue examination and a questionnaire-based interview. The chi-square test was used to test the differences in prevalence of oral precancerous lesions and conditions by different "life styles" relating to current risk habits of current areca quid chewing, smoking, and alcohol drinking. To control for possible confounding, a logistic regression model was used to estimate the Odds Ratios (OR) for leukoplakia and oral submucous fibrosis (OSF).
  
  
  RESULTS
  136 precancerous lesions and conditions were detected among 1075 subjects (12.7%). The analysis of the spectrum of oral precancerous disorders detected, leukoplakia (n = 80), OSF (n = 17) and verrucous lesions (n = 9), demonstrated an association with gender (P < 0.001). There were statistically significant associations among leukoplakia (P < 0.01), OSF (P < 0.0001), and verrucous lesions (P < 0.0001) and the life style of current areca quid chewing, smoking, and alcohol drinking. The synergistic effect of smoking and areca quid chewing habit on leukoplakia and OSF was demonstrated.
  
  
  CONCLUSIONS
  This study reinforces the association of current areca quid chewing without tobacco, cigarette smoking, and alcohol drinking to leukoplakia, OSF, and verrucous lesions in Taiwan.
authors.affiliation: Graduate Institutes of Dental Sciences, Oral Health Sciences and Oral Health Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ching-Hung
authors.initials: CH
authors.lastname: Chung
authors.forename: Yi-Hsin
authors.initials: YH
authors.lastname: Yang
authors.forename: Tung-Yiu
authors.initials: TY
authors.lastname: Wang
authors.forename: Tien-Yu
authors.initials: TY
authors.lastname: Shieh
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D001114:Areca / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004919:Erythroplasia / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007972:Leukoplakia, Oral / Q000453:epidemiology / Q000209:etiology; D017676:Lichen Planus, Oral / Q000453:epidemiology / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D009914:Oral Submucous Fibrosis / Q000453:epidemiology / Q000209:etiology; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014860:Warts / Q000453:epidemiology / Q000209:etiology