Cytological Diagnosis of Oral Squamous Cell Carcinoma: Correlation with Tobacco, Alcohol and Betel Nut Use in a High-Risk Population

Abstract

Background: Oral squamous cell carcinoma (OSCC) is one of the most common types of oral cancer, particularly in regions where tobacco and betel nut use are prevalent. This study aimed to assess the cytological diagnosis of OSCC and precancerous lesions and explore their correlation with risk factors such as age, gender, and lifestyle habits including tobacco, alcohol, and betel nut use. Methods: A retrospective study of 600 patients was conducted, focusing on the cytological evaluation of oral lesions. Patients were categorized by age, gender, and lifestyle habits, and cytological smears were analyzed to identify malignant and premalignant lesions. Statistical analyses were performed using chi-square tests to determine the significance of associations between risk factors and malignancy. Results: Of the 600 patients, 51.2% were diagnosed with OSCC, while 39.2% had premalignant lesions. The majority of the cases occurred in the 41-50 age group (33%) and 81.3% of the patients were male. Although tobacco use was associated with a higher incidence of malignancy (52.5%) compared to non-users (44.2%), the association was not statistically significant (p = 0.279). Alcohol use also did not show a significant correlation with malignancy (p = 0.156). However, ill-fitting dentures were found to have a significant association with malignancy (p = 0.006), suggesting a mechanical contribution to cancer risk. Conclusion: The study underscores the high prevalence of OSCC, particularly among males aged 41-50 in Kanpur. While tobacco and alcohol use were not significantly linked to malignancy in this cohort, the significant correlation with ill-fitting dentures highlights the need for better oral health care. Early detection and intervention remain crucial for improving outcomes, especially in high-risk groups.