title: Smokeless tobacco use in Pakistan and its association with oropharyngeal cancer.
abstract: Smokeless tobacco (ST), widely used in Pakistan, poses a high risk for oral cancer. Our hospital-based data illustrate that oropharyngeal cancer (9.9%) is the second leading malignancy after breast cancer (16.1%), and is significantly higher than in other Member States of the World Health Organization's Eastern Mediterranean Region. Urdu-speaking communities had a proportionately higher rate of oropharyngeal cancer (20.4%), followed by Balochis (19.9%), Sindhis (16.8%), Punjabis (11.7%) and Pashtuns (9.6%). Association of oropharyngeal cancer with ST use was four times higher relative to no history of tobacco use after adjustingfor age, ethnicity and gender. Our findings also show a predominance of this cancer among males relative to females and one-third of the reported cases occurred among individuals under 40 years. These findings have significant social impact, indicating the need for urgent intervention against the use of ST.
authors.affiliation: World Health Organization, Country Office, Islamabad, Pakistan. bilek@pak.emro.who.int
authors.forename: K M
authors.initials: KM
authors.lastname: Bile
authors.forename: J A
authors.initials: JA
authors.lastname: Shaikh
authors.forename: H U R
authors.initials: HU
authors.lastname: Afridi
authors.forename: Y
authors.initials: Y
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D010154:Pakistan / Q000453:epidemiology; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D055815:Young Adult