title: Prevalence of oral cancer and pre-cancer and associated risk factors among tea estate workers in the central Sri Lanka.
abstract: BACKGROUND
  To screen for oral cancer or not is being debated, but for high-risk populations with minimal access to regular dental care systematic oral examinations could provide some benefit.
  
  
  METHODS
  We undertook oral mucosal examinations of labourers employed in tea estate plantations in Sri Lanka. In a two-stage screening procedure, first by estate medical officers and then by visiting specialists, we examined 12 716 persons at their workplaces achieving a coverage of one-sixth of the total workforce.
  
  
  RESULTS
  Fourteen oral cancers and 848 subjects with oral pre-cancer (6.7%) were detected giving population prevalences of 46.1 per 1000 for leukoplakia and 16.4 per 1000 for oral submucous fibrosis. Among subjects with any oral mucosal disorder (n = 1159) proportions of current users of betel quid, smokers and alcohol use was recorded at 92%, 31% and 61% respectively. The synergistic effect of these three risk habits on the development of oral leukoplakia was evident in mixed habit groups.
  
  
  CONCLUSIONS
  The prevalence of oral pre-cancer in tea estate labourers was higher than estimates reported in previous studies. In the absence of state-sponsored preventive activities, it is necessary to improve the capacity of individual health practitioners and small medical centres to participate in oral health promotion and oral cancer/pre-cancer screening.
authors.affiliation: Department of Oral Medicine, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
authors.forename: A
authors.initials: A
authors.lastname: Ariyawardana
authors.forename: M A M
authors.initials: MA
authors.lastname: Sitheeque
authors.forename: A W
authors.initials: AW
authors.lastname: Ranasinghe
authors.forename: I
authors.initials: I
authors.lastname: Perera
authors.forename: W M
authors.initials: WM
authors.lastname: Tilakaratne
authors.forename: E A P D
authors.initials: EA
authors.lastname: Amaratunga
authors.forename: Yi-Hsin
authors.initials: YH
authors.lastname: Yang
authors.forename: S
authors.initials: S
authors.lastname: Warnakulasuriya
mesh_terms: D000293:Adolescent; D000328:Adult; D000383:Agriculture / Q000706:statistics & numerical data*; D000428:Alcohol Drinking; D001114:Areca; D016009:Chi-Square Distribution; D005260:Female; D006282:Health Personnel / Q000193:education; D006801:Humans; D007972:Leukoplakia, Oral / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology*; D016017:Odds Ratio; D011230:Precancerous Conditions / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking; D013188:Sri Lanka / Q000453:epidemiology; D013662:Tea
chemical_list: D013662:Tea