Epidemiology and Risk Factors of Oral Cancer and Precancerous Lesions

Orofaringealni je karcinom po ČestoĆi peti karcinom u muškaraca i sedmi u Žena (prosjeČno Šesti) s jakom zemljopisnom pojavnošću. Među 46 zemalja Mađarska ima najveću smrtnost od orofaringealnoga karcinoma i u mušakraca i u žena, a Hrvatska na toj ljestvici zauzima treće mjesto. Od sredine šezdesetih godina prošloga stoljeća nastaje drastičan porast smrtnosti u središnjim europskim zemljama. U Mađarskoj je, na primjer, smrtnost u tome razdoblju peterostruko porasla. Uživanje duhana i alkohola glavni je uzrok oralnoga karcinoma i ta je veza jasno pokazana u suvremenim znanstvenim procjenama. Premda je znatno smanjena upotreba duhana u sjevernoj Americi i sjevernoj Europi, zadnjih nekoliko desetljeća to se nije dogodilo i u istočnoj i južnoj Europi. Tako su Poljska, Grčka i Mađarska tri zemlje s najvećom potrošnjom cigareta po stanovniku među 111 zemalja iz cijeloga svijeta i ta se je potrošnja povećala tijekom posljednjih dvadeset godina.Visoka potrošnja alkohola u zemljama s vodećom smrtnošću od oralnoga karcinoma, posebice u Mađarskoj, također je poznata. Međusobno djelovanje i/ili zbrajanje djelovanja pušenja i konzumiranja alkohola može biti važno u porastu toga rizika. Smrtnost od ciroze jetre, povezane s konzumiranjem alkohola, u Mađarskoj je iznimno visoka. Oralne bolesti u vezi s pušenjem i/ili konzumiranjem alkohola, kao što su oralni karcinom i leukoplakija, pokazuju u Mađarskoj visoku rasprostranjenost. Uzorak oralnih leukoplakija, s tendencijom razvoja u oralni karcinom, definiran je nakon višegodišnjega znanstvenog praćenja. Mrljasti ili erozivni tip leukoplakija pokazao je najveću sklonost alteraciji i prema tome bi ga trebalo smatrati rizičnom vrstom leukoplakija. Te žalosne statistike postoje usprkos činjenici da je oralni karcinom moguće dijagnosticirati pregledom i palpacijom. Novi mađarski zdravstveni program posvećuje posebnu pozornost oralnom karcinomu, daje preporuke za primarnu prevenciju i ističe ulogu stomatologa i liječenika u sekundarnoj prevenciji, a sve sa svrhom da se što ranije postavi dijagnoza bolesti.Oro-pharyngeal cancer is the fifth most common cancer in men, and the seventh in womne (sixth overall), with marked georgaphical variations. For this site, Hungary has the highest mortality rate among 46 countries, both in males and females, Croatia occupies the third place in male oro-pharyngeal cancer mortality. Since the mid 1960-s, a dramatic increase in mortality has been observed in all Centrall european countries. In Hungary, the oral cancer death rate has shown more that a five-fold increase within this time period. Tobaco use and alcohol consumption are the leading causes of oral cancer, and this relationship is clearly demonstrated in recentassessments. Although there has been a steady reduction in tobacco use in North America and Northen Europe over the past decades, this has not occured in Eastern and Southern Europe. In fact Poland, Greece and Hungary represent three nations with the highest per capita cigarette consumption among 111 countries worldwide, and this rate has increased over the past twenty years. The high level of alcohol consumption in countries with the leading mortality rates- especially Hungaryis also well known. The interaction and/or summation of smoking and alcohol consumption may play a role in augmenting the risk. The mortality in liver cirrhosis - generally linked with alcohol consumption - is in Hungary extremly high. Oral diseases attributable to smoking and/or alcohol consumption, such as oral cancer and oral leukoplakia, show a high prevalence in Hungary. A group of oral leukoplakias, more likely to develop oral cancer, has been defined based on long-term follow-up studies, where the speckled (erosive) type of leukoplakias showed the highest malignancy rate, and therefore could be considered as a risk group for oral leukoplakias. These sad statistics are there, in spite of the fact that oral cancer is accessible both for the eyes, as well as for the palpating hands. Therefore, the new Hungarian Health Program pays special attention to oral cancer, involving recommendations for primary prevention, as well as accentuating the role of the dentist and physician in secondary prevention enabling early diagnosis

Ugradnja Lantanida u caklinu ljudskih zuba

The incorporation of lanthanides in human dental enamel was investigated by means o f X-ray microprobe analysis. Sound human premolar teeth - after extraction-were prepared and kept for 60 days in 10% solutions of neodymium-, samariumeuropium-, ytterbium resp. lanthanum-chloride at room temperature with constant shaking. Results of the X-ray microprobe analysis revealed 100-140 m depth penetration and incorporation o f neodymium, with transformation o f the apatite phases of enamel into neodymium-hydroxil-apatite-, resp. neodymium- hidrochlor-apatite. The changes were accompanied by a decrease in the values o f calcium, magnesium and sodium. Samarium- , ytterbium-, europium and lanthanum-chloride treatments produced a phosphate-complex containing coherent layer on the enamel surface. However, no real incorporation into the apatite-lattice was observed. The incorporation o f neodymium-apatites, and the formation of cerium-apatite into the dental enamel observed in previous studies might indicate the possibility of stabilizing the apatite structure, and discovering new ways of caries prevention.U radu je istraživana ugradnja lantanida u humanu caklinu zuba s pom oću rendgenske mikroanalize.Zdravi ljudski prem olari su poslije vađenja priprem ljeni i držani kroz 60 dana u 10% otopinama neodijsamarij, iterbij i lantanij klorida na sobnoj tem peraturi uz trajno m iješanje. Rezultati rendgenske m ikroanalize objelodanili su i potvrdili prodor i ugradnju neodija, s preobrazbom apatita cakline u neodij - -hidroxil-apatit. Promjene su bile praćene smanjenjem vrijednosti kalcija, magnezija i kalija. Samarij, iterbij, europij i lantanij klorid u postupku su uzrokovali stvaranje kompleksa fosfata stvarajući čvrst sloj na caklinskoj površini. M eđutim, prava ugradnja u caklinsku strukturu nije primijećena. Inkorporacija neodij apatita i stvaranje cerij apatita, što je bilo prim ijećeno u prethodnim studijama, moglo bi ukazivati na mogućnost stabilizacija apatitne strukture i otkriće novih putova prevencije karijesa

The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan

In areas where the practise of betel quid chewing is widespread and the chewers also often smoke and drink alcohol, the relation between oral precancerous lesion and condition to the three habits is probably complex. To explore such association and their attributable effect on oral leukoplakia (OL) and oral submucous fibrosis (OSF), a gender–age-matched case–control study was conducted at Kaohsiung, southern Taiwan. This study included 219 patients with newly diagnosed and histologically confirmed OL or OSF, and 876 randomly selected community controls. All information was collected by a structured questionnaire through in-person interviews. A preponderance of younger patients had OSF, while a predominance of older patients had OL. Betel quid chewing was strongly associated with both these oral diseases, the attributable fraction of OL being 73.2% and of OSF 85.4%. While the heterogeneity in risk for areca nut chewing across the two diseases was not apparent, betel quid chewing patients with OSF experienced a higher risk at each exposure level of chewing duration, quantity and cumulative measure than those who had OL. Alcohol intake did not appear to be a risk factor. However, cigarette smoking had a significant contribution to the risk of OL, and modified the effect of chewing based on an additive interaction model. For the two oral premalignant diseases combined, 86.5% was attributable to chewing and smoking. Our results suggested that, although betel quid chewing was a major cause for both OL and OSF, its effect might be difference between the two diseases. Cigarette smoking has a modifying effect in the development of oral leukoplakia

Smoking and drinking in relation to oral potentially malignant disorders in Puerto Rico: a case-control study

<p>Abstract</p> <p>Background</p> <p>Oral cancer incidence is high on the Island of Puerto Rico (PR), particularly among males. As part of a larger study conducted in PR, we evaluated smoking and drinking as risk factors for oral potentially malignant disorders (OPMDs).</p> <p>Methods</p> <p>Persons diagnosed with either an OPMD (n = 86) [oral epithelial dysplasia (OED), oral hyperkeratosis/epithelial hyperplasia without OED] or a benign oral tissue condition (n = 155) were identified through PR pathology laboratories. Subjects were interviewed using a standardized, structured questionnaire that obtained information, including detailed histories of smoking and drinking. Odds ratios (ORs) for smoking and drinking in relation to having an OPMD, relative to persons with a benign oral tissue condition, were obtained using logistic regression and adjusted for age, gender, education, fruit/vegetable intake and smoking or drinking.</p> <p>Results</p> <p>For persons with an OPMD and relative to individuals with a benign oral tissue condition, the adjusted OR for current smoking was 4.32 (95% CI: 1.99-9.38), while for former smokers, the OR_adjwas 1.47 (95% CI: 0.67-3.21), each OR_adjrelative to never smokers. With regard to drinking, no adjusted ORs approached statistical significance, and few point estimates exceeded 1.0, whether consumption was defined in terms of ever, current, level (drinks/week), or beverage type.</p> <p>Conclusions</p> <p>In this study, conducted in Puerto Rico, current smoking was a substantial risk factor for OPMDs while former smokers had a considerably reduced risk compared to current smokers. There was little evidence suggesting that alcohol consumption was positively associated with OPMD risk.</p

Ugradnja Lantanida u caklinu ljudskih zuba

The incorporation of lanthanides in human dental enamel was investigated by means o f X-ray microprobe analysis. Sound human premolar teeth - after extraction-were prepared and kept for 60 days in 10% solutions of neodymium-, samariumeuropium-, ytterbium resp. lanthanum-chloride at room temperature with constant shaking. Results of the X-ray microprobe analysis revealed 100-140 m depth penetration and incorporation o f neodymium, with transformation o f the apatite phases of enamel into neodymium-hydroxil-apatite-, resp. neodymium- hidrochlor-apatite. The changes were accompanied by a decrease in the values o f calcium, magnesium and sodium. Samarium- , ytterbium-, europium and lanthanum-chloride treatments produced a phosphate-complex containing coherent layer on the enamel surface. However, no real incorporation into the apatite-lattice was observed. The incorporation o f neodymium-apatites, and the formation of cerium-apatite into the dental enamel observed in previous studies might indicate the possibility of stabilizing the apatite structure, and discovering new ways of caries prevention.U radu je istraživana ugradnja lantanida u humanu caklinu zuba s pom oću rendgenske mikroanalize.Zdravi ljudski prem olari su poslije vađenja priprem ljeni i držani kroz 60 dana u 10% otopinama neodijsamarij, iterbij i lantanij klorida na sobnoj tem peraturi uz trajno m iješanje. Rezultati rendgenske m ikroanalize objelodanili su i potvrdili prodor i ugradnju neodija, s preobrazbom apatita cakline u neodij - -hidroxil-apatit. Promjene su bile praćene smanjenjem vrijednosti kalcija, magnezija i kalija. Samarij, iterbij, europij i lantanij klorid u postupku su uzrokovali stvaranje kompleksa fosfata stvarajući čvrst sloj na caklinskoj površini. M eđutim, prava ugradnja u caklinsku strukturu nije primijećena. Inkorporacija neodij apatita i stvaranje cerij apatita, što je bilo prim ijećeno u prethodnim studijama, moglo bi ukazivati na mogućnost stabilizacija apatitne strukture i otkriće novih putova prevencije karijesa