UICC World Cancer Congress 2006

Objective: ARECA QUID (AQ) and GUTKHA, are common chewing products gaining an increasing popularity among the Indian population, especially among the youngsters responsible for the causation of CANCER & ORAL SUBMUCOUS FIBROSIS..Objective is to evaluate oral and oesophageal involvement .

Methods:Case Control study of 318 clinically cases of OSMF of which 44 endoscopic evaluation for oesophageal involvement.

Results:Most common habit was that of Gutkha and kharra (a crude local product with similar constituents as gutkha). Oral complaints included restricted mouth opening (79%), burning sensation on eating hot & spicy food (88%) & oral ulcerations (56%). Histopathological evaluation of oral submucous fibrosis revealed atrophic or acanthotic, often parakeratinised mucosa, subepithelial hyalinization and dense collagen bundles. Cancer was seen to be associated in 6% of cases and dysplasia in 72% cases. Endoscopy of these patients revealed abnormalities in 81.8% cases. Oesophageal biopsies revealed typical oesophageal subepithelial fibrosis in only 29% cases, more commonly in histologically moderately advanced cases of oral SMF who had an interincisal opening in the range of 17-23mm and primarily in the age group<30yrs. Dysplasia was appreciated in 27% & Barret's oesophagus in 15.4% cases, both strongly related to subsequent malignant transformation. As submucous fibrosis is considered a premalignant condition, such associations with oesophageal SMF may have far reaching implications. The present study thus confirms both clinically and histopathologically, both oral and oesophageal involvement in OSMF patients especially among areca quid and gutkha chewers.