title: Betel-quid chewing with or without tobacco is a major risk factor for oral potentially malignant disorders in Sri Lanka: a case-control study.
abstract: We investigated the prevalence of, and risk factors for, oral potentially malignant disorders (OPMDs) in rural Sri Lanka. A cross-sectional community-based study was conducted by interview and oral examination of 1029 subjects aged over 30 years. A community-based nested case-control study then took those with OPMDs as 'cases', "controls" being those with no oral abnormalities at time of initial screening. The prevalence of OPMD was 11.3% (95% CI: 9.4-13.2), after weighting for place of residence and gender. Risk factors were betel-quid (BQ) chewing daily [OR=10.6 (95% CI: 3.6-31.0)] and alcohol drinking daily or weekly [OR=3.55 (1.6-8.0)]. A significant dose-response relationship existed for BQ chewing. Smoking did not emerge when adjusted for covariates. A synergistic effect of chewing and alcohol consumption existed. The attributable risk (AR) of daily BQ chewing was 90.6%, the population AR 84%. This study demonstrates high prevalence of OPMD, betel-quid chewing with or without tobacco being the major risk factor.
authors.affiliation: Dental Institute, Maharagama, Sri Lanka. hemanthaamarasinghe@yahoo.com
authors.forename: Hemantha K
authors.initials: HK
authors.lastname: Amarasinghe
authors.forename: Udaya S
authors.initials: US
authors.lastname: Usgodaarachchi
authors.forename: Newell W
authors.initials: NW
authors.lastname: Johnson
authors.forename: Ratilal
authors.initials: R
authors.lastname: Lalloo
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D001114:Areca / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced* / Q000453:epidemiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007972:Leukoplakia, Oral / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D011230:Precancerous Conditions / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013188:Sri Lanka / Q000453:epidemiology