Abstract
Introduction
Oral cancer is associated with several well-known risk factors, including the use
of betel quid, alcohol consumption, and tobacco smoking. Studies regarding oral cancer
risk factors vary based on the different subgroups identified in the Indian context.
Objectives
This systematic review, meta-analysis, and meta-regression aggregate data from various
studies on oral cavity cancer risk factors in India.
Materials and Methods
From September 20 to 30, 2024, we searched for English studies on PubMed, ScienceDirect,
and Google Scholar. Two independent reviewers selected studies based on title/abstract
and full text, with adjudication by a third author. We utilized the JBI checklist
for critical appraisal of case–control studies. The data provided information on participant
demographics, cases and controls, evaluated risk factors, and odds ratios. A random
effects model produced pooled estimates for each risk factor.
Results
Fifteen case–control studies conducted in the Indian population were included in the
analysis. Our meta-analysis concludes that any form of tobacco use is the primary
risk factor for oral cavity cancer, with risk rising consistently alongside the duration
of use. Additionally, daily alcohol consumption significantly increases this risk.
Chronic trauma to the oral mucosa also plays a substantial role in the development
of oral cavity cancer. Sensitivity analysis and meta-regression indicated that factors
such as sample sizes, case–control ratio, and study region had no significant impact.
Funnel plots assessing publication bias in studies reporting tobacco smoking and chewing
revealed no significant asymmetry, and Egger's test was nonsignificant (p > 0.05).
Conclusion
There is sufficient evidence for the role of tobacco in both smoking and smokeless
forms as a risk factor for oral cavity cancer in India.
Keywords
risk factors - oral cancer - systematic review - meta-regression - India
