oral cancer

2. M.Aqeel Maqsood
Roll# 146

3. Epidemiology , Etiology and Prevention
of Oral cancer

4. What is Cancer?

5. Defined as:_
• An uncontrolled,
uncoordinated, excessive
and abnormal growth of
cells is called cancer.

6. Benign Vs. Malignant
• Does not spread
• Rarely life threatening
• Can be removed
• Spreads to other parts
of the body
• Life threatening
• Can be removed, but
it may grow back

7. Types of Cancer
• Benign
• Malignant
– Carcinoma
• epithelial origin
• E.g. squamous cell carcinoma
– Sarcoma
• Mesenchymal origin

8. Oral cancer
• Defined as:_
Indurated, ulcerated lump or sore that
may or may not be painful and is often
associated cervical lymph adenopathy.

10. Why is it such an important public
health issue?
• Closely associated with tobacco and alcohol.
• 2nd most common cause of death
• In 2003-according to world health report 7.1
million deaths were reported.
• Estimated 50% increase in death rate in next 20
years.
• In Bangladesh, Sirilanka and Pakistan most
common type of cancer.
• And 1/3rd of all the cancers.

11. Signs and Symptoms
• Sores that do not heal
within 14 days
• Bleeding in mouth
• Lump in neck
• Earache
• Loose teeth
• Dentures will not fit
well
• Pain or numbness in
mouth
• Difficulty chewing or
swallowing
• Bad breath
• Patches on the lip or
in the mouth that are
red, white, or a
mixture of both

12. Epidemiology of oral cancer

13. Host factors
1. Age
– Incidence increases with age.
– 98% cases in the west are over 40yrs old.
– More than 50% of cases include ages above 50yrs.
2. Gender
– Incidence is more in
• Men
• Industrial areas
– Women have more incidence of lip carcinoma
– Men have high incidence of buccal carcinoma
3. Occupation
–
Textile workers and leather industries have high incidence of
buccal cavity and larynx carcinoma.

14. Host Factors
4. Immunity
– AIDS patients are prone to Kaposi carcinoma.
5. Social Class
6. Custom and habits
7. Race

15. Agent Factors
• Biological
– HIV
– Candida
• Chemical
– Arsenic,dyes,nickel,chromium
• Mechanical
– Ill fitting dentures
– Sores from jagged teeth

16. Agent factors
• Nutritional
–
–
–
–
–
Precarcinogens in food
Increase consumption of fat
Deficiency in folic acid
Deficiency of proteins
Increase in red chili

17. Environmental factors
• Water contamination
• Air pollution
• Geographic variation
– Netherland buccal mucosa
– Switzerland lip and tongue
– Canadian Eskimos salivary glands
• Solar heat
– Prolonged exposure causes melanoma

18. Etiology
• Due to
–
–
–
–
–
–
–
Tobacco
Unhealthy diet
Alcohol
Physical inactivity
Infection
Nutrients
Physical irritants

19. Risk Factors
• Tobacco is the main culprit
– Mainly chewing tobacco
– 75% of those diagnosed are tobacco users.
• Alcohol 2nd largest risk factor
• Combination of alcohol and tobacco use
– 15x greater risk for oral cancer
• Excessive sun exposure
– Lip cancer
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Oral Cancer
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20. Risk Factors
• X-rays
– Cumulative exposure
• Other biological factors
– Viruses and fungus
– HPV 16
• Main agent in cervical cancer
• Now has been linked to oral cancer
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Oral Cancer
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21. Tobacco
• Its an important risk factor of oral cancer.
• 90% of cancers are caused by tobacco
• Tobacco can be broadly classified into smokeless
and smoking forms.

23. Bidi
• Most popular
form of
tobacco
• Estimated
nictinic
content is
1.7-3mg

24. Cigar
• Cured
tobacco
wrapped in
dried tobacco
leaves.

25. Chilum
• Conical clay pipe
for smoking
tobacco
• Filed with coarsely
cut tobacco pieces
• Glowing charcoal
is kept on top of
tobacco

26. Hookah
• Indinan
origin
• Also
known as
water pipe.

27. Cigerrete
• 1gram tobacco
cured by sunlight
is coverred by
paper.
• 1-1.4mg Nicotinic
content.
• More common in
urban areas

29. Paan
• Most common
habit of smokeles
tobacco.
• May also include
•
•
•
•
•
Cardamom
Cocnut
Clove
Sugar
Tobacco wraped
in beetle leave

30. Snuff
• Finely
powdered air
cured and fire
cured tobacco
leaves.

31. Mishri
• Prepared by
roasting
tobacco on hot
metal plate then
powdered
• Also used to
clean the teeth

32. Khaini
• Powdered
sundried
tobacco.
• Simply placed
in mouth and
chewed

33. Mainpuri
Tobacco
• Ingredients
include
•
•
•
•
Tobacco
Slaked lime
Camphor
cloves

36. Primary
Program to
educate
adolescence
Program for
tobacco
users
Regular
check up
good oral
hygiene

37. Secondary
Screening
Referral
Early
detection

38. Tertiary
• Surgery
• Chemotherapy
– Cytotoxic drugs
• Radiotherapy

39. What you can do:
•
•
•
•
•
Make yourself aware or your mouth
Stop smoking and drinking excessively
Be informed
Have a good diet and stay healthy
Behavioural modification

40. Prevention as a dentist
• Regular check up
• Suspected patients be thoroughly checked
• Patient should be educated about the preventive
aspects of oral cancers including
– Behavioral
– Physical
– community