Description
Background: Tobacco is regarded as one of the primary etiologic factors in causing oral cancer. Oxidative species, including reactive oxygen species (ROS), are components of normal cellular metabolism and are required for intracellular processes as varied as proliferation, signal transduction, and apoptosis. In the situation of chronic oxidative stress, however, ROS are involved in multiple stages of carcinogenesis. The aim of this study was to assess the effect of tobacco on oral epithelial cells and oxidant/antioxidant balance in the oral cavities of tobacco consumers in Bafoussam West Region Cameroon.
Method: A cross sectional study of 120 participants, 21 years and above, over a period of two months in some travelling agencies in Bafoussam was done. Participants were grouped according to tobacco consumption into two. After consenting, saliva and buccal smears were collected from which Malondialdehyde (oxidative stress marker) and oral epithelial changes were determined. Oral epithelial changes assessed included hyperkeratosis, tobacco hyperkeratosis, non-specific inflammatory changes and oral microflora and Malondialdehyde was determined using the Thiobarbituric acid method. Data was analyzed using SPSS version 22.0
Results: of the 120 participants recruited, male tobacco consumers made 48.3% while female tobacco consumers made 5.7% with a mean tobacco consumption age of 26 years old. Smoking was the method most used where 66% smoked for more than 10 years and 50% smoked more than 10 sticks per day. Normal buccal smears were found in 24.1% of the total population with 8.3% from consumers and 15.8% from non-consumers. A statistical significant relationship was found between tobacco consumption and oral epithelial changes (p<0.001). Only tobacco consumers presented with tobacco hyperkeratotic buccal smears (20%) when compared with the control group. A statistically significant relationship was found between tobacco consumption and salivary MDA (p<0.001). Tobacco consumers had higher mean MDA (0.20±0.145 SD µM/ml) than non-consumers (0.09±0.067 SD µM/ml). The highest mean MDA was seen in individuals with tobacco hyperkeratotic buccal smears (0.28±0.163 SD µM/ml). A strongly positive statistically significant correlation was found between salivary MDA and oral epithelial changes (r=0.204, p=0.026 at 0.05CI).
Conclusion: Tobacco consumption severely increases the risk for developing oral mucosal proliferative lesions, and the level of oxidative stress in the saliva of individuals in the study population. Therefore there is need for intensive education of the population on the health dangers associated to tobacco consumption and implementation of tobacco control programs so as to reduce the risk for developing oral cancers and other health problems associated to tobacco consumption.
Key words: Tobacco, Oxidative stress, Malondialdehyde, Oral cancer.
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