title: Impact of Toombak dipping in the etiology of oral cancer: gender-exclusive hazard in the Sudan.
abstract: BACKGROUND
  Oral cancer (OC) mortality is very high in Sudan, particularly among men due to the habit of Toombak use (tobacco specific nitrose amine (TSN)) rich tobacco.
  
  
  OBJECTIVE
  Our aim was to determine whether OC is gender-specific due to increased Toombak use among males as suggested a risk for subsequent development of oral cancer.
  
  
  METHODS
  We conducted a descriptive study of OC in Khartoum and obtained information on Toombak use, confounding variables for 39 incident patients with oral cancerous lesions and 43 hospital-based cases without apparent oral lesions.
  
  
  METHODS
  OC was affirmed by histopathology for all patients with oral lesions, hence oral epithelial atypia and leukoplakias were detected using cytology.
  
  
  METHODS
  Data analyzed using a computer SPSS program.
  
  
  CONCLUSIONS
  Of the 82 subjects, there were 57 (70%) Toombak users and 25 (30%) non-tobacco users. Among the 39 patients with OC, 24 (61.5%) were Toombak users and 15 (38.5%) were non-tobacco users. Among 43 with atypical changes, 10 (23.3%) were non-tobacco users and 33 (76.7%) were Toombak users. Regarding gender, only 11 (13.4%) were females, of whom 8 (72.7%) were non-tobacco users. We conclude that oral cancer, atypia and leukoplakia were high among males who were Toombak users. In view of the high incidence (29%) of OC due to Toombak use, we propose the implementation of oral screening programme restricted to Toombak users.
authors.affiliation: Department of Histopathology and Cytology, Faculty of Medical Laboratory Science, University of Khartoum, Sudan. hussaingad@hotmail.com
authors.forename: Hussain G
authors.initials: HG
authors.lastname: Ahmed
authors.forename: Rayan M
authors.initials: RM
authors.lastname: Mahgoob
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D013397:Sudan / Q000453:epidemiology; D014030:Tobacco, Smokeless / Q000633:toxicity*