Betel-quid chewing with or without tobacco is a major risk factor for oral potentially malignant disorders in Sri Lanka: A case-control study

Amarasinghe, Hemantha K.; Usgodaarachchi, Udaya S.; Johnson, Newell W.; Lalloo, Ratilal; Warnakulasuriya, Saman

doi:10.1016/j.oraloncology.2010.01.017

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Volume 46, Issue 4 , Pages 297-301, April 2010

Betel-quid chewing with or without tobacco is a major risk factor for oral potentially malignant disorders in Sri Lanka: A case-control study

Hemantha K. Amarasinghe
- Dental Institute, Maharagama, Sri Lanka
- Corresponding author. Address: School of Dentistry and Oral Health, Gold Coast Campus, Griffith University, QLD 4222, Australia. Tel.: +61 (0)756780771; fax: +61 (0)756780708.
Udaya S. Usgodaarachchi
- Dental Institute, Colombo 7, Sri Lanka
Newell W. Johnson
- Griffith Institute for Health and Medical Research, Gold Coast Campus, Griffith University, QLD 4222, Australia
Ratilal Lalloo
- Colgate Chair: Rural, Remote and Indigenous Oral Health, School of Dentistry and Oral Health, Gold Coast Campus, Griffith University, QLD 4222, Australia
Saman Warnakulasuriya
- Department of Oral Medicine and Experimental Oral Pathology, King’s College Dental Institute, Bessemer Road, London SES 9RS, United Kingdom

Received 10 January 2010; received in revised form 22 January 2010; accepted 22 January 2010. published online 02 March 2010.

Summary

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 30years. 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.