Oral leukoplakia and erythroplakia in young patients: a systematic review.

OBJECTIVE: The aim of this study was to estimate the frequency of oral leukoplakia and oral erythroplakia in young patients. STUDY DESIGN: The systematic review was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and performed in the following electronic databases: PubMed, Scopus, and Embase. The studies included were cross-sectional, cohort, and diagnostic, which provided with clinical and microscopic data of patients younger than 40 years. The Critical Appraisal Checklist for Prevalence Studies from the Joanna Briggs Institute and the Quality Assessment Tool for Diagnostic Accuracy Studies were used to assess the risk of bias. RESULTS: Five studies met eligibility criteria and were included. The total number of patients from the studies was 1246, of which 115 were young patients (9.2%) with oral leukoplakia as the only oral potentially malignant disorder reported. Oral epithelial dysplasia was identified in 40 cases (34.7%), of which 8 (6.9%) presented malignant transformation. CONCLUSIONS: The frequency of oral leukoplakia is low in young patients. Observational studies are necessary for understanding oral leukoplakia and other oral potentially malignant disorders in younger patients.

Evaluación clínico-epidemiológica de trastornos bucales potencialmente malignos en adultos de Montalvo en Ambato, Ecuador / Clinical-epidemiological evaluation of potentially malignant oral disorders in adults of Montalvo in Ambato, Ecuador

RESUMEN Introducción: Las neoplasias de cabeza y cuello representan el 17,6 por ciento a nivel mundial. El cáncer de la cavidad bucal es uno de los más comunes que aparece en dicha región; el 95 por ciento corresponde a carcinoma epidermoide con un pobre pronóstico de supervivencia, debido a que algunos se desarrollan a partir de trastornos potencialmente malignos peligrosamente asintomáticos, por lo que su detección precoz es imprescindible. Objetivo: Caracterizar los trastornos bucales potencialmente malignos mediante aspectos epidemiológicos, clínicos y topográficos en adultos atendidos en el subcentro de salud de Montalvo. Métodos: Se realizó un estudio descriptivo y transversal en 99 pacientes atendidos en el subcentro de salud de Montalvo en Ambato, Ecuador, desde noviembre de 2012 a enero de 2013. Los datos fueron recogidos en la historia clínica estomatológica, que incluyó: datos generales, interrogatorio y examen físico de la cavidad bucal. Los trastornos bucales potencialmente malignos que se consideraron fueron la leucoplasia, eritroleucoplasia, eritroplasia y paladar del fumador invertido. Se aplicó la estadística descriptiva y el estadígrafo chi cuadrado de Sperman. Se trabajó con confidencialidad en el manejo de los datos obtenidos y con la autorización correspondiente al consentimiento. Resultados: Los pacientes con más de 60 años representaron el grupo de edad más afectado para el 60,6 por ciento, con un predominio del sexo femenino (54,5 por ciento). El color de la piel no tuvo una diferencia significativa. El trastorno más frecuente fue la leucoplasia (30 por ciento), seguida de la eritroleucoplasia (15 por ciento) y la eritroplasia (11 por ciento). El 75,8 por ciento de los pacientes no presentó síntomas, sin embargo, el 73 por ciento de los casos con lesiones presentó trauma físico. La localización más frecuente de la leucoplasia fue la mucosa del carrillo y la base de la lengua. Conclusiones: La leucoplasia, la eritroleucoplasia y la eritroplasia fueron los trastornos bucales potencialmente malignos más frecuentes, localizados con mayor frecuencia en la base de la lengua y la mucosa del carrillo, con un predominio en los pacientes mayores de 60 años y en las mujeres(AU)

ABSTRACT Introduction: Head and neck neoplasms represent 17.6 percent worldwide. Cancer of the oral cavity is one of the most common that appear in this region, being 95 percent epidermoid carcinoma with a poor prognosis of survival because they develop from premalignant lesions dangerously asymptomatic, the reason why the precocious detection is imperative. Objective: Characterize potentially malignant oral disorders through epidemiological, clinical and topographical aspects in adults served at the Montalvo health subcenter. Methods: A descriptive and cross-sectional study was conducted on 99 patients treated at the Montalvo health subcentre in Ambato, Ecuador, from November 2012 to January 2013. The data were collected in the stomatological medical history, which included: general data, interrogation and physical examination of the oral cavity. The potentially malignant oral disorders considered were leukoplakia, erythroleukoplakia, erythroplasia and the palate of the inverted smoker. The descriptive statistic and the Sperman chi square statisticwast were applied. It was worked with confidentiality in the handling of the data obtained and with the authorization corresponding to the consent. Results: Patients over 60 years of age accounted for the most affected age group for 60.6 percent, with a female predominance (54.5 percent). The skin color did not make a significant difference. The most common disorder was leukoplakia (30 percent), followed by erythroleukoplakia (15 percent) erythroplasia (11 percent). 75.8 percent of patients had no symptoms, however 73 percent of injured cases had physical trauma. The most common location of leukoplakia was the mucosa of the cheek and the base of the tongue. Conclusion: Leukoplakia, erythroleukoplakia and erythroplasia were the most common potentially malignant oral disorders, most commonly located at the base of the tongue and mucosa of the carrillo, with predominance in patients over 60 years of age and in patients over 60 years of age and in Women(AU)

Smokeless tobacco use and oral neoplasia among urban Indian women.

OBJECTIVES: Oral cavity cancers are fourth most common cancers among Indian women. The objectives were to create cancer awareness (CA) and screen tobacco-using women for oral cavity cancers. MATERIALS AND METHODS: A community-based CA and screening programme was conducted among women in Mumbai, India. The tobacco-using women participated in CA and oral cavity screening by oral visual inspection (OVI). All screen-positive women were referred to nodal hospital and assisted for diagnostic confirmation and treatment completion. RESULTS: Twelve slum clusters comprising of 138,383 population and 13,492 tobacco-using women have been covered. Among them, 11,895 (88.2%) participated in CA and 11,768 (87.2%) in OVI. A total of 377 (3.2%) women were screened positive, 275 (72.9%) complied with referral and 207 oral precancers [173 leukoplakia, 9 erythroplakia, 3 erythroleukoplakia and 41 sub-mucus fibrosis (SMF) including 35 women with multiple precancers] and 7 oral cancers were diagnosed. The detection rate of oral precancerous lesions and oral cancers was 17.6 and 0.6 per 1,000 screened women. Thirty-five women had multiple oral precancerous lesions. The results of multivariate analysis indicate dose-response relationship between tobacco use and risk of oral precancers. CONCLUSION: Good participation rates (>85%) for cancer awareness and OVI were seen among urban slum women in India. Many oral precancer and cancer cases were detected and were managed at the nodal hospital.

Impact of oral potentially malignant disorder subtypes on all-cause and cause-specific mortality in males.

OBJECTIVES: To quantify the effect of oral potentially malignant disorder (OPMD) subtypes on mortality from oral cancer and type 2 diabetes among areca nut chewers and/or cigarette smokers. MATERIALS AND METHODS: A retrospective cohort design was devised to follow 14,749 men attending community-based screening program for oral cancer between 1998 and 2000 and followed until 2010. The Cox proportional hazards regression model was applied to assess the effect of OPMD on death. RESULTS: A total of 1,291(8.75%) patients were detected as OPMD. Among those free of T2DM at baseline, the elevated risk for death from T2DM was noted for OSF (aHR = 3.62, 95% CI: 1.25-10.51) and erythroplakia (aHR = 5.01, 95% CI: 1.17-21.45). The elevated risk for all-cause death for OPMD was mainly explained by deaths from oral cancer and T2DM but not other causes of death. CONCLUSIONS: Oral potentially malignant disorder, particularly OSF and erythroplakia, in male cigarette smokers and/or areca nut chewers led to an incremental elevated risk of T2DM mortality in the way of being distal to the occurrence of T2DM, implying that early detection and prevention of OPMD may not only reduce oral cancer mortality but also result in the reduction of T2DM mortality.

Prevalence of oral potentially malignant disorders: A systematic review and meta-analysis.

Oral potentially malignant disorders (OPMD) are chronic conditions, which have a higher risk of transformation to oral squamous cell carcinoma. The aim of this systematic review and meta-analysis was to answer the question: "What is the prevalence of oral potentially malignant disorders among adults?" Studies reporting the prevalence of these conditions (leukoplakia, erythroplakia, oral submucous fibrosis [OSMF], and actinic cheilitis) were selected, only studies in which a clinical assessment and histopathological confirmation were performed were included. Of the 5513 studies, 22 met the inclusion criteria for qualitative and quantitative analyses. The risk of bias (RoB) of the selected studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Seven studies were classified as high risk, 12 as moderate risk, and 3 as low RoB. The meta-analysis showed that the prevalence of OPMD was 4.47% (95% CI = 2.43-7.08). The most prevalent OPMDs were OSMF (4.96%; 95% CI = 2.28-8.62) and leukoplakia (4.11%; 95% CI = 1.98-6.97). OPMDs were identified more commonly in males (59.99%; 95% CI = 41.27-77.30). Asian and South American/Caribbean populations had the highest prevalence rates of 10.54% (95% CI = 4.60-18.55) and 3.93% (95% CI = 2.43-5.77), respectively. The overall prevalence of OPMD worldwide was 4.47%, and males were more frequently affected by these disorders. The prevalence of OPMD differs between populations; therefore, further population-based studies may contribute to the better understanding of these differences.

Oral erythroplakia-What is it?

Oral erythroplakia is a rare type of lesion, and little is known about the origin of the lesion. It has traditionally been described as the red counterpart of oral leukoplakia, which implies that it is a red lesion that cannot be characterized clinically or pathologically as any other definable lesion. A definition by exclusion is less satisfactory than a positive description to define a lesion, and as erythroplakia probably is related to lichenoid lesions, a new approach to perceive the lesion is proposed based on the clinical features of a fiery red, sharply demarcated lesion situated at a slightly lower level than the surrounding mucosa. Such a definition would probably help clinicians distinguish erythroplakia from other red lesions of the oral mucosa. Although the course of such lesions varies, a significant proportion will develop malignancy, which is why they should be followed at short intervals.

[Precancerous lesions of the buccal epithelium]. / Les lésions précancéreuses épithéliales buccales.

Squamous cell carcinomas of the oral cavity and lips consistently have a high incidence (they constitute the fifth most common form of cancer in France) and carry a heavy prognosis, particularly if diagnosed late. According to different studies, between 10 and 80% of such carcinomas occur in a pre-existing or precancerous lesion. The World Health Organisation (WHO) recommends the use of two terms for such lesions: precursor lesions, i.e. histological lesions associated with intraepithelial neoplasia (IEN) and verrucous hyperplasia (VH), frequently resulting clinically in leukoplakia or erythroplakia; "at risk" lesions, which include lichen planus, submucosal oral fibrosis and certain forms of genodermatosis.

Potentially malignant oral lesions: clinicopathological correlations.

OBJECTIVE: To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects. METHODS: The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05). RESULTS: Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each). CONCLUSION: In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.

Prevalence and factors associated with oral potentially malignant disorders in Brazil's rural workers.

OBJECTIVES: To determine the prevalence of oral potentially malignant disorders (OPMDs) in a population of rural workers in the northeast of Brazil and to investigate the association with sociodemographic, occupational, and health factors. METHODS: A total of 1385 workers answered a validated questionnaire and were examined by calibrated dentists. A descriptive analysis, chi-square homogeneity test, and binary logistic regression were performed. RESULTS: The prevalence of OPMDs was 29.6%. Actinic cheilitis was the most predominant (28.4%), followed by leukoplakia (2.3%) and erythroplakia (0.3%). Gender, type of skin, and time exposed to the sun explained the presence of OPMD (P < 0.0001). The study found increased prevalence, especially for males over the age of 60 years and being exposed to the sun for more than 45 years. CONCLUSION: Rural workers showed high vulnerability to the presence of OPMDs, as estimated prevalence exhibited was high.

Potentially malignant oral lesions: clinicopathological correlations / Lesões orais potencialmente malignas: correlações clínico-patológicas

ABSTRACT Objective To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects. Methods The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05). Results Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each). Conclusion In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.

RESUMO Objetivo Verificar a incidência das lesões orais potencialmente malignas, e avaliar e correlacionar seus aspectos clínico-patológicos. Métodos A amostra foi composta pelos casos diagnosticados clinicamente como leucoplasia oral, eritroplasia oral, eritroleucoplasia, queilite actínica e líquen plano oral em um serviço de diagnóstico no período entre maio de 2012 e julho de 2013. Foram realizados testes estatísticos adotando-se nível de significância de 5% (p≤0,05). Resultados Dos 340 pacientes examinados, 106 (31,2%) se apresentaram com lesões orais potencialmente malignas; destes, 61 (17,9%) biópsias foram realizadas. A lesão mais frequente foi a queilite actínica (37,5%), e o sítio anatômico mais acometido foi o lábio inferior (49,6%). Entre os 106 pacientes da amostra, 48 (45,3%) relataram consumo de nicotina, 35 (33%) ingeriam bebidas alcoólicas e 34 (32,1%) trabalhavam expostos ao sol. Comparando o diagnóstico clínico com o histopatológico, as lesões que apresentaram maior compatibilidade foram a eritroplasia oral e a lesão ulcerada atípica (100% ambas). Conclusão Na maioria dos casos, houve compatibilidade do diagnóstico clínico com o histopatológico. Notou-se correlação entre a ocorrência de eritroplasia, leucoplasia e eritroleucoplasia com o hábito de fumar, e entre a queilite actínica com a exposição solar. A eritroleucoplasia foi a lesão que demonstrou maior grau de malignização neste estudo. Diante do exposto, recomenda-se maior atenção por parte dos cirurgiões-dentistas ao diagnóstico das lesões orais potencialmente malignas, para aplicação da melhor conduta e controle da lesão, impedindo sua transformação maligna.

[Oral precancer and cancer]. / Precáncer y cáncer bucal.

We reviewed the concept of oral precancerous lesions, oral cancer, and the possibility of early diagnosis. With the keywords: premalignant oral lesions prevention, a search was performed over the past 10 years. Also clinical trials are searched from January 2011 until today with the keywords: oral cancer prevention AND dentistry. It is emphasized that there can be no significant changes related to the concept of precancerous lesions and cancer, and those relating to the early diagnosis. Despite the numerous described methods of screening, biopsy remains the most useful test, and therefore it is essential, mainly if we consider the new possibilities of molecular studies.

Avaliação clínica e histopatológica e hábitos associados ao surgimento de leucoplasias e eritroplasias orais / Clinical and histopathological evaluation and habits associated with the onset of oral leukoplakia and erythroplakia

Objective: This research aims to establish the prevalence, factors associated with the onset, and clinical and histopathological features of oral leukoplakia and erythroplakia, so that these data can contribute to the prevention of these lesions and, consequently, of oral cancer. Material and method: A retrospective study was conducted at a reference service of Universidade Federal do Rio Grande do Norte (UFRN) from 2000 to 2012. To verify the association of variables, Pearson's chi-squared test and Fisher's exact test (p ≤ 0.05) were used. Results: Among 6,560 investigated records, 54 cases were selected, of which 44.4% were male and 55.6% female, with mean age of 56.93 years. Regarding habits, 72.2% were smokers and 25% were alcohol users; 17.9% showed association of both habits. Oral leukoplakia lesions were the most prevalent (0.65%) and oral erythroplakia showed greater association with malignancy in the histopathological presentation (p = 0.001). Most lesions showed no symptoms (p = 0.004). The most frequent was oral leukoplakia in smoking women, with mean age of 57 years. Conclusion: Knowledge of associated factors and clinical characteristics of oral leukoplakia and erythroplakia is essential for establishing the correct diagnosis and treatment...

Objetivo: Esta pesquisa objetiva estabelecer a prevalência, os fatores associados ao surgimento e as características clínicas e histopatológicas das leucoplasias e eritroplasias orais, a fim de que estes dados possam contribuir na estratégia de prevenção ao desenvolvimento dessas lesões e, consequentemente, do câncer oral. Material e método: Foi realizado estudo retrospectivo em um serviço de referência da Universidade Federal do Rio Grande do Norte (UFRN) no período de 2000 a 2012. Para verificar a associação das variáveis foi utilizado o teste qui-quadrado e o exato de Fisher (p ≤ 0,05). Resultados: Foram investigados 6.560 prontuários, tendo sido selecionados 54 casos, dos quais 44,4% do sexo masculino e 55,6% do feminino, com idade média de 56,93 anos. Com relação aos hábitos, 72,2% eram fumantes e 25% usuários de álcool, sendo que 17,9% exibiam associação dos dois hábitos. As leucoplasias orais foram as lesões mais prevalentes (0,65%), e as eritroplasias orais apresentaram maior associação com apresentação maligna no diagnóstico histopatológico (p = 0,001). A maioria das lesões não apresentou sintomatologia (p = 0,004). A leucoplasia oral foi mais frequente em mulheres fumantes com média de idade de 57 anos. Conclusão: O conhecimento dos fatores associados e das características clínicas das eritroplasias e leucoplasias orais é essencial para o estabelecimento do correto diagnóstico e tratamento...

Accuracy of screening for potentially malignant disorders of the oral mucosa by dentists in primary care.

PURPOSE: To examine the accuracy of a screening programme for potentially malignant disorders of the oral mucosa by visual inspection in primary health care. MATERIALS AND METHODS: The study was based on secondary data from the Primary Care Information System maintained by seven units of family health in São Paulo City managed by a non-governmental agency. The reference population was composed of 15,072 residents 50 years old or more of both genders. The study population comprised 2,980 individuals. During screening in community settings, the oral mucosa was examined by trained dentists and distributed into two categories: (a) screen negative (b) screen positive. All participants underwent comprehensive clinical exams by a general dental practitioner supervised by a specialist. Individual records were grouped in a working dataset. Point and 95% confidence interval estimates were calculated regarding measures of sensitivity (Se), specificity (Sp) and positive and negative predictive values (PPV and NPV, respectively). RESULTS: 18.0% of the population was considered screen positive. A total of 133 lesions (4.5%) were identified and 8 cases of oral cancer were confirmed, which corresponded to a prevalence rate of 27 cases in 10,000 people, a much higher rate than expected. The measures found were Se: 91.7% (85.3-95.6), Sp: 85.4% (84.1-86.7), PPV: 22.7% (19.3-26.5), NPV: 99.5% (99.2-99.8). The visual screen presented high accuracy. CONCLUSION: The test presented high sensibility and specificity values. From a public health point of view, the high accuracy levels showed the importance of oral health teams on family health strategy for more comprehensive primary care. Targeting risk groups and delegating the screening to community health agents may improve PPV and coverage.

Prevalence of oral lesions in the dental office.

Comprehensive head and neck examinations provide the best opportunity to carefully evaluate the oral cavity for the presence of disease. For this study, 40 dental professionals in 20 dental offices in Northern Ohio received a three-hour standardization course on oral pathology, performed head and neck examinations on all adult patients over a three-week period, and recorded the presumptive identification of all observed oral lesions. Lesion-positive and lesion-negative patients were compared on patient age, gender, tobacco usage, denture status, and the type of provider (dentist or hygienist) making the observations. Providers performed head and neck examinations on 3,182 adults, 847 (26.7%) of whom had 1,073 lesions. Lesion-positive and negative patients were similar in terms of age and gender, although patients with lesions were almost twice as likely to use tobacco and more than 2.5 times as likely to wear dentures. Most lesions were classified as white (36.6%), followed by red (17%), ulcerated (14%), pigmented (14%), and soft tissue enlargements (12%). Leukoplakia and erythroplakia were observed in 1% of the screened adults, although patients were not aware of the presence of these conditions. Overall, the prevalence of lesions in dental patients (26.7%) was similar to national estimates (27.9%), but the prevalence of some specific lesions varied.

[Oral erythroplakia and erythroleukoplakia: red and red-white dysplastic lesions of the oral mucosa--part 1: epidemiology, etiology, histopathology and differential diagnosis]. / Erythroplakie und Erythroleukoplakie: Rote und rot-weisse Risikoläsionen der Mundhöhlenschleimhaut. Teil 1: Epidemiologie, Atiologie, Histopathologie und Differenzialdiagnose.

Oral erythroplakia (OE) and oral erythroleukoplakia (OEL; synonym: speckled leukoplakia) are working diagnoses for red and red-white lesions of the oral mucosa after exclusion of all other possible diagnoses for lesions with a similar clinical appearance. A good knowledge of oral medicine and possible differential diagnoses of oral mucosal pathologies is mandatory to correctly detect OE and OEL on this exclusion basis. In the present review article in a series of two, epidemiologic data, etiologic factors, possible differential diagnoses, and the histopathologic characteristics of OE and OEL will be presented and discussed regarding the current literature. A thorough histopathologic examination of these epithelial precursor lesions is mandatory to recognise the presence and the severity of epithelial dysplasia, which is a decisive factor for the subsequent treatment planning.

Natural history of potentially malignant oral lesions and conditions: an overview of the literature.

At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Pre-cancer in the UK issues related to potentially malignant disorders of the oral cavity were discussed by an expert group. The consensus views of the Working Group are presented in a series of papers. In this report we review the literature on the epidemiology and natural history of potentially malignant disorders (PMD), detailing those characteristics of the patients and lesions thought to be associated with future development of oral squamous cell carcinoma (OSCC). Older patients, particularly females are more at risk than younger patients; the duration of PMD may be important. Those who have never used tobacco seem at greater risk than smokers. OSCC is more likely with PMD on the lateral and ventral tongue, floor of mouth and retromolar/soft palate complex than with those elsewhere. The vast majority of PMD in which OSCC develop are non-homogenous although 5% of homogenous PMD will develop carcinoma. Large lesions covering several intraoral subsites also appear more at risk.

A clinicopathologic study of oral leukoplakia and erythroplakia in a Thai population.

OBJECTIVES: To determine the prevalence of oral leukoplakia and erythroplakia in a group of Thai patients and to study the clinical and pathologic features of these 2 lesions. METHOD AND MATERIALS: Cases having provisional diagnoses of leukoplakia and erythroplakia between 1973 and 2004 were retrieved from the files of the Department of Oral Pathology, Faculty of Dentistry, Mahidol University. Clinical and pathologic features were reviewed and analyzed. RESULTS: Of 7,177 biopsy specimens, 123 cases (1.7%) of leukoplakia and 9 cases (0.13%) of erythroplakia were found. There was no significant gender predilection in leukoplakia (male:female = 1.2:1). The peak of age-frequency distribution of leukoplakia was in the fourth decade among men and fifth decade among women. The most common site of leukoplakia was buccal mucosa (28.5%), followed by alveolar mucosa (18.7%) and tongue (16.3%). Microscopic study of leukoplakia revealed hyperkeratosis with or without acanthosis in 60.9% of cases, epithelial dysplasia in 10.6%, and squamous cell carcinoma in 4.9%. Erythroplakia was found in 6 men and 3 women. It was most frequently seen during the seventh decade of life. The palate was the most common site. Epithelial dysplasia and squamous cell carcinoma were found in 6 patients with erythroplakia (66.7%). CONCLUSIONS: Leukoplakia occurred 13 times more frequently than erythroplakia. However, squamous cell carcinoma was more frequently found in erythroplakia cases. Both lesions were found most frequently in elderly individuals and affected men more than women.

Oral cancer and pre-cancer in Myanmar: a short review.

Cancer in Myanmar is one of the 10 leading causes of morbidity and mortality. In 1974, the Yangon Cancer Registry was established. From 1974 to 2001 a total of 85 298 cancer cases were registered. From 1963 to 1972 the average annual incidence rate of oral cancer was calculated to be 363 per 100 000 population. The tongue was mostly affected (31.2%). In one study, the prevalence of oral leukoplakia was 1.7%, erythroplakia 0.1%, and submucous fibrosis 0.1%. No epidemiologic studies of the prevalence of betel quid chewing (BQC) in Myanmar have been performed. One study showed that among 773 individuals over the age of 6 years, 46.4% were habitual smokers. A recent symposium on oral health stressed the necessity to introduce concepts of prevention, focusing on BQC habits and smoking as high-risk factors for oral cancer and pre-cancer in Myanmar.

Riesgo probable de cáncer bucal y lesiones precancerosas en mujeres mayores de 30 años residentes en las comunidades de Cumboto y La Trilla, en Ocumare de la Costa, Edo, Aragua, 2004 / Probable risk of oral cancer and precancerous lesions in women aged over 30 living at the communities of Cumboto and La Trilla, at Ocumare de la Costa, Edo, Aragua, 2004

Se expone un estudio realizado en la población de Ocumare de La Costa, Municipio Mario Briceño Iragorri, Edo. Aragua, para determinar la incidencia de Cáncer Bucal (CB) y lesiones precancerosas en mujeres mayores de 30 años; algunas de ellas tienen por hábito el fumar el cigarrillo de forma invertida, término conocido coloquialmente como: candela pa´dentro, mientras lavan sus ropas en los ríos locales. La muestra obtenida fue de 20 mujeres, que habitan en las localidades de: Cumboto y La Trilla. Dichas mujeres fueron estudiadas durante un período de 5 semanas correspondientes a los meses de Julio y Agosto del año 2004, determinándose que el 36,36 por ciento de las mismas, presentaron lesiones precancerosas en su cavidad bucal en la zona de las comisuras labiales y la lengua. Ninguno de los casos estudiados mostró lesiones cancerosas a nivel bucal, a pesar que constituyen un grupo de alto riesgo, debido a los hábitos que practican.