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Background <p>Oral cancer represents a critical and escalating public health challenge in South Asia, with buccal and gingivobuccal sulcus (GBS) subsites disproportionately affected due to the pervasive use of areca nut and betel quid. Despite this burden, there is limited evidence from Bangladesh on the sociodemographic and behavioral determinants that drive subsite-specific risk. This study aimed to identify and quantify the key determinants of buccal and GBS cancers, addressing an urgent evidence gap to inform prevention strategies and policy interventions.</p> Methods <p>A multicenter, hospital-based cross-sectional study was conducted among 456 histologically confirmed OSCC patients recruited from three tertiary hospitals. Data were collected using a validated, expert-reviewed, and pilot-tested questionnaire, supplemented by pathology reports for diagnostic accuracy. Analyses were performed in Stata 17, including univariate, bivariate, and multivariate logistic regression. Model adequacy was confirmed through Hosmer–Lemeshow goodness-of-fit tests (<i>p</i> &gt; 0.10), and collinearity was excluded using correlation matrices (<i>r</i> &lt; 0.70). Results were reported as adjusted odds ratios (AOR) with 95% confidence intervals.</p> Results <p>Over half of the cases originated in the buccal region (53.9%). Long-term betel quid chewing (&gt; 20 years) emerged as the strongest predictor, tripling the odds of buccal/GBS cancer (AOR: 3.0; 95% CI: 1.2–7.7). Occupational status was significant, with service workers twice as likely to develop buccal/GBS cancers compared to non-workers (AOR: 2.2; 95% CI: 1.2–4.2). Primary education reduced risk (AOR: 0.5; 95% CI: 0.3–0.9). Other lifestyle exposures showed no independent associations.</p> Conclusion <p>This study provides robust, subsite-specific evidence underscoring the carcinogenic impact of prolonged quid chewing and the modifying roles of occupation and education. Findings call for urgent regulatory control of areca nut products, integration of targeted screening into primary care, and culturally tailored interventions for vulnerable groups to reduce the escalating burden of OSCC in Bangladesh.</p>

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Sociodemographic and lifestyle determinants of oral squamous cell carcinoma at buccal and gingivobuccal sulcus sites: multicenter hospital-based cross-sectional study

  • 期刊论文

  • 发表日期：

    2025年10月30日

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  • Wasif Imran,
  • Nahid Hassan Nishan,
  • Monzur Rahman Bhuiyan,
  • Tasmin Jahan Hazari

摘要

Background

Oral cancer represents a critical and escalating public health challenge in South Asia, with buccal and gingivobuccal sulcus (GBS) subsites disproportionately affected due to the pervasive use of areca nut and betel quid. Despite this burden, there is limited evidence from Bangladesh on the sociodemographic and behavioral determinants that drive subsite-specific risk. This study aimed to identify and quantify the key determinants of buccal and GBS cancers, addressing an urgent evidence gap to inform prevention strategies and policy interventions.

Methods

A multicenter, hospital-based cross-sectional study was conducted among 456 histologically confirmed OSCC patients recruited from three tertiary hospitals. Data were collected using a validated, expert-reviewed, and pilot-tested questionnaire, supplemented by pathology reports for diagnostic accuracy. Analyses were performed in Stata 17, including univariate, bivariate, and multivariate logistic regression. Model adequacy was confirmed through Hosmer–Lemeshow goodness-of-fit tests (p > 0.10), and collinearity was excluded using correlation matrices (r < 0.70). Results were reported as adjusted odds ratios (AOR) with 95% confidence intervals.

Results

Over half of the cases originated in the buccal region (53.9%). Long-term betel quid chewing (> 20 years) emerged as the strongest predictor, tripling the odds of buccal/GBS cancer (AOR: 3.0; 95% CI: 1.2–7.7). Occupational status was significant, with service workers twice as likely to develop buccal/GBS cancers compared to non-workers (AOR: 2.2; 95% CI: 1.2–4.2). Primary education reduced risk (AOR: 0.5; 95% CI: 0.3–0.9). Other lifestyle exposures showed no independent associations.

Conclusion

This study provides robust, subsite-specific evidence underscoring the carcinogenic impact of prolonged quid chewing and the modifying roles of occupation and education. Findings call for urgent regulatory control of areca nut products, integration of targeted screening into primary care, and culturally tailored interventions for vulnerable groups to reduce the escalating burden of OSCC in Bangladesh.