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BRIEF RESUME ON INTENDEND WORK INTRODUCTION The oral cavity and pharynx combined is the sixth commonest site of cancer in both sexes. In many countries the mortality rate is increasing among younger men . A causal role in the etiology of mouth cancer has been established for tobacco use, both smoking and chewing, separately and in conjunction with betel quid chewing; with alcohol consumption and, less certainly, with other factors such as poor oral hygiene, nutritional factors and certain occupational exposures. In Asian societies, a high attributable risk can be ascribed to cigarette smoking and betel chewing. Oropharyngeal cancer is an important form of cancer, and one for which practical prospects for prevention already exist. Against this background of a continually increasing trend among younger persons, it seems essential to engage upon programmes of prevention, including increasing awareness for early detection, against Oropharyngeal cancer At present, the highest incidence rates of mouth cancer in men are to be found in Bas-Rhin, France (13.5 per 100 000), Poona (8.4) and chennai (8.1) in India, Sao Paulo, Brazil (8.0) and Doubs, France (8.0). [All rates shall be the directly-adjusted, annual, age standardized rates per 100 000 person-years using the World Standard Population (as described in ref 3) unless otherwise stated in the text.] Rates are also high in Calvados, France (6.9) and Bombay, India (6.5). The lowest incidence rates are reported from Northern European countries, Eastern European countries and Japanese and Chinese population groups.
Rates in women, overall, are generally lower than in men although the highest female rate (Bangalore) was higher than the highest recorded male rate. Interestingly, the five highest rates recorded in women are from the five regions of India (Bangalore 15.7, chennai 10.0, Poona 6.3, Bombay 5.0 and Nagpur 4.6). Rates of mouth cancer in Britain are generally intermediate in each sex. Overall, the incidence in each sex is higher in Scotland than England and Wales (men 2.0 and 1.2; women 0.8 and 0.5). Around 1975, the incidence of mouth cancer in men appeared almost double in 'urban' as opposed to 'rural' areas of the same region (Table 2). This excess was observed in 14 of 16 regions where the necessary data were available. Using data from around 1980, the pattern was not so clear although 6 out of 11 regions had higher rates in urban areas than in rural areas. Of the seven regions with such data covering both time periods, the excess of mouth cancer observed in urban areas of Miyagi, Japan and Doubs, France both disappeared between these observation points. Oral cancer is one of the few forms of malignant disease which is increasing notably in many countries of the developed and developing world. It is a disease which has attracted relatively little attention from epidemiologists compared to many other forms of cancer. Cigarette smoking and alcohol consumption have clearly been identified as important etiological risk factors for mouth cancer in the developed world. In the developing world, There is also evidence that mouth cancer risk increases with the use of oral snuff and suggestions that dietary factors may also be of importance in the etiology of this disease. At the present time it does not appear that occupational factors are important causes of mouth cancer and the role of mouthwash, dentition and other risk factors, such as Candida albicans, herpes simplex or human papilloma virus infection, remain unclear WT. There has recently been a number of important publications on the epidemiology of oral cancer.
Prospects for the prevention of mouth cancer clearly do exist. Reduction of tobacco smoking and alcohol consumption would bring about substantial declines in the frequency of mouth cancer in developed countries. Reductions in cigarette smoking and betel chewing would bring about similar reductions in the Indian subcontinent. Another possible factor in reducing mortality from mouth cancer would be an increased awareness of mouth cancer among dentists, clinicians and the general public which could possibly lead to earlier diagnosis. Hence, the importance of structured teaching programme among alcoholics and smokers is highly influential for the prevention of this rrisk factors which may result in oral and pharyngeal cancer.
NEED FOR THE STUDY Alcohol and tobacco, alone or in combination, are associated with an increased risk of various cancers, including those of the upper aero-digestive tract and liver. Both alcohol and tobacco use can increase the risk of cancer of the oral cavity and throat (pharynx), and their combined use has a multiplicative effect on risk. Moreover, those regions of the mouth and pharynx that are more directly exposed to alcohol or tobacco are more likely to be affected by cancer than other regions. A similar effect was found with respect to cancer of the voice box (larynx). For squamous cell carcinoma of the esophagus, alcohol and tobacco also appear to increase risk synergistically. With liver cancer, in contrast, alcohol consumption and tobacco use appear to be independent risk factors.
KEY WORDS: Alcohol and tobacco; alcohol consumption; ethanol; smoking; tobacco use; multiple drug use; cancer; risk factors; relative risk; populationattributable risk; oral cancer; pharyngeal cancer; laryngeal cancer; esophageal cancer; liver cancer; hepatocellular carcinoma.
Both alcohol and tobacco use are associated with numerous adverse health consequences, including an increased risk of certain types of cancer. For example, epidemiological studies found that alcohol consumption can increase the risk for cancers of the upper aero-digestive tract, stomach, large bowel (i.e., colon and rectum), liver, and breast, with higher levels of consumption leading to greater increases in risk (Bagnardi et al. 2001). Similarly, tobacco use is associated with an elevated risk of lung cancer, as well as of cancers of the upper aero-digestive tract, bladder, kidney, pancreas, stomach, and cervix and a certain type of leukemia (International Agency for Research on Cancer [IARC] 2004). Many people use and abuse both alcohol and tobacco, and their combined effects on cancer risk also have been widely investigated. This article summarizes those findings, focusing on cancers at sites that are most directly exposed during alcohol and tobacco consumption--that is, the upper aerodigestive tract (i.e., the oral cavity, throat [pharynx], voice box [larynx], and esophagus) and the liver. ORAL AND PHARYNGEAL CANCER In developed countries, oral and pharyngeal cancers rarely occur in people who neither smoke nor drink alcohol. However, many epidemiological studies conducted over the last three decades in the Americas, Europe, and Asia have provided strong evidence of an association between alcohol and tobacco use (both separately and in combination) and an increased risk of oral and pharyngeal tumors (Blot et al. 1988; Franceschi et al. 1990; Zheng et al. 1990, 2004).
Risk Associated With Alcohol Consumption: The risk of both oral and pharyngeal cancer rises steeply with the level of alcohol consumption. An analysis that pooled data (i.e., a meta-analysis) from 26 studies of oral and pharyngeal cancers found that consumption of 25, 50, or 100 g pure alcohol/day (1) was associated with a pooled relative risk (RR) of 1.75, 2.85, and 6.01, respectively, of oral and pharyngeal cancer (see Table 1) (Bagnardi et al. 2001). The RR indicates the strength of the relationship between a variable (e.g., alcohol consumption) and a given disease or type of cancer. People without the exposure (e.g., nondrinkers) are assigned a RR of 1.0. A RR greater than 1.0 indicates that the variable (e.g., drinking) increases the risk for that disease; furthermore, the greater the RR, the greater the association. Thus, the meta-analysis clearly demonstrated that the RR for oral or pharyngeal cancer increased significantly with increasing amounts of alcohol consumed. Similarly, another study conducted in Switzerland and Italy found that nonsmokers who consumed five or more drinks per day had a five-fold increased risk of these cancers compared with nondrinkers (Talamini et al. 1998). The relationship between duration of alcohol consumption and risk of oral or pharyngeal cancer is less consistent. Moreover, the effect of drinking cessation on the RR for oral or pharyngeal cancer is unclear. Thus, it appears that the RR for these types of cancer appreciably declines only after 15 to 20 years of abstinence (Hayes et al. 1999). Several studies also evaluated the effects of different types of alcoholic beverages on cancer risk. These analyses found that cancer risk generally was increased regardless of the type of beverage consumed. Moreover, the magnitude of the association between different types of beverages and cancer risk was inconsistent across studies and populations. In general, the beverage most frequently consumed in a population was associated with the highest risk of oral and pharyngeal cancer in that population (Boffetta and Hashibe 2006).
“A STUDY TO ASSESS THE KNOWLEDGE REGARDING OROPHARYNGEAL CANCER AND ITS ASSOCIATION WITH ALCOHOL CONSUMPTION AND SMOKING AMONG INDUSTRIAL WORKERS AT SELECTED INDUSTRIES IN BANGALORE WITH A VIEW TO DEVELOP A SIM”
OBJECTIVE 1.Assess the pretest knowledge of adult industrial workers regarding association of oral and pharyngeal cancer with alcohol consumption and smoking. 2.Assess the post test knowledge of adult industrial workers regarding association of oral and pharyngeal cancer with alcohol consumption and smoking. OPERATIONAL DEFINITION
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