title: Assessing the Risk of Oral Cancer associated with Gutka and Other Smokeless Tobacco Products: A Case-control Study.
abstract: BACKGROUND
  Tobacco and tobacco-related products have been attributed to be causative factors for oral cancer. Newer, chewable, and commercially available smokeless tobacco (ST) products, such as gutka pose further threat in this direction. The aim of the study was to evaluate the risk of oral cancer associated with gutka and other ST products.
  
  
  METHODS
  A case-control study of 134 cases and 134 controls, over a period of 6 months (July-December 2014), was carried out at the Baqai University, Karachi, Pakistan. An interview-based questionnaire was used to collect data on sociodemographic characteristics, oral hygiene practices and type, duration, and frequency of use of tobacco-related products. Data were analyzed using the Pearson's chi-square (χ2) test with the level of significance set as p < 0.05.
  
  
  RESULTS
  Gutka showed the highest odds ratio toward developing oral cancer ratio among all the tobacco-related products [odds ratio (OR) 5.54; 95% CI 2.83-10.83; p < 0.001)]. Participants who consumed other ST products also showed 2 to 4 times higher odds ratio of developing oral cancer than compared to those who did not consume these products.
  
  
  CONCLUSIONS
  The study provided strong evidence that gutka and other ST products are independent risk factors for oral cancer.
  
  
  CONCLUSIONS
  This study highlights the strong association of different types of ST and oral cancer. This results in identification of high-risk groups for targeted screening for potential oral cancer lesions.
authors.affiliation: Department of Oral Medicine and Diagnostic Sciences College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia, Phone: +096614677422, e-mail: kamranhabibawan@gmail.com.
authors.forename: K H
authors.initials: KH
authors.lastname: Awan
authors.affiliation: Department of Oral Medicine and Diagnostic Sciences College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Q A
authors.initials: QA
authors.lastname: Hussain
authors.affiliation: Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry Jazan University, Jazan, Kingdom of Saudi Arabia.
authors.forename: Shankargouda
authors.initials: S
authors.lastname: Patil
authors.affiliation: Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry Jazan University, Jazan, Kingdom of Saudi Arabia.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Maralingannavar
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*; D009910:Oral Hygiene; D010154:Pakistan / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014030:Tobacco, Smokeless / Q000009:adverse effects*
keywords: Betel quid; Case-control; Gutka; Oral cancer Smokeless tobacco.