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| *Total Saudi patients by province, total habit-proximity oral cancer sites** and total malignant cases referred to KFSH & RC (1976-1995) | |||
|---|---|---|---|
| Province | Total habit-proximity sites | Total malignant cases | Ratio |
| Asir | 55 | 1,979 | 1:36 |
| Al Baha | 14 | 619 | 1:44 |
| Eastern Province | 82 | 3,996 | 1:49 |
| Hail | 11 | 735 | 1:67 |
| Al Jouf | 3 | 431 | 1:144 |
| Jizan | 281 | 1,496 | 1:5 |
| Madina | 43 | 1,587 | 1:37 |
| Makkah | 122 | 4,994 | 1:41 |
| Najran | 19 | 553 | 1:29 |
| Northern Province | 5 | 348 | 1:70 |
| Qassim | 14 | 1,434 | 1:102 |
| Riyadh | 130 | 7,798 | 1:60 |
| Tabuk | 15 | 540 | 1:36 |
| Total KSA | 794 | 26,510 | 1:33 |
*The purpose of this study was to explore the possible relationship between a smokeless tobacco preparation called shamma (shamma is a mixture of powdered tobacco, carbonate of line ash, black pepper, oils and flavouring) and oral cancer in the Kingdom of Saudi Arabia (KSA). Tumour Registry data from the King Faisal Specialist Hospital and Research Centre (KFSH & RC) were reviewed for the period from 1976 to 1995.
**Shamma quid is habitually placed in the lower half of the oral cavity - mandibular buccal sulcus, mandibular labial sulcus and floor of the mouth. These oral cancer sites being in the proximity of where the shamma is habitually placed is called "habit-proximity oral cancer sites".
Source: Allard WF. et al. Smokeless tobacco (shamma) and oral cancer in Saudi Arabia. Community Dent Oral Epidemiol 1999; 27: 398-405.
| Total Saudi patients by province, total non habit-proximity oral cancer sites, total malignant cases and population referred to KFSH & RC (1976-1995) | |||
|---|---|---|---|
| Province | Non-habit-proximity oral cancer sites1 (%) | Total malignant cases2 (%) | Saudi province population3 (%) |
| Asir | 10.6 | 7.5 | 9.3 |
| Al Baha | 1.8 | 2.3 | 2.4 |
| Eastern Province | 15.9 | 15.1 | 15.4 |
| Hail | 1.8 | 2.8 | 2.8 |
| Al Jouf | 0.0 | 1.6 | 1.8 |
| Jizan | 6.2 | 5.6 | 6.0 |
| Madina | 3.5 | 6.0 | 6.8 |
| Makkah | 29.1 | 18.8 | 22.6 |
| Najran | 2.7 | 2.1 | 2.0 |
| Northern Province | 0.9 | 1.3 | 1,4 |
| Qassim | 2.7 | 5.4 | 5.0 |
| Riyadh | 23.0 | 29.4 | 21.2 |
| Tabuk | 1.8 | 2.0 | 3.3 |
| Total KSA | 100 | 100 | 100 |
1Non-habit-proximity oral cancer sites of province as percentage of total KSA non-habit-proximity oral cancer sites
2Total malignant cases of province as percentage of total KSA malignant cases
3Saudi province population as percentage of total KSA Saudi population
The percentage referral of non-habit-proximity oral cancer sites (oral cancers not related to the site where shamma is habitually placed) from Jizan province was only 6.2% when compared to 35.4% of habit-proximity oral cancer sites from the same province.
Source: Allard WF. et al. Smokeless tobacco (shamma) and oral cancer in Saudi Arabia. Community Dent Oral Epidemiol 1999; 27: 398-405.
| Total Saudi patients by province and habit-proximity oral cancer site referred to KFSH & RC (1976-1995) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Province | Mucosa of lower lip | Lower gum | Tongue | Floor of mouth | Cheek mucosa | Vestibule of mouth | Retromolar area | Total | % |
| Asir | 1 | 10 | 30 | 5 | 6 | 1 | 2 | 55 | 6.9 |
| Al Baha | - | 1 | 9 | 1 | 2 | - | 1 | 14 | 1.8 |
| Eastern Province | 1 | 17 | 40 | 8 | 13 | - | 3 | 82 | 10.3 |
| Hail | - | 1 | 4 | 1 | 3 | - | 2 | 11 | 1.4 |
| Al Jouf | - | 1 | 1 | 1 | - | - | - | 3 | 0.4 |
| Jizan | 6 | 84 | 116 | 24 | 40 | 2 | 9 | 281 | 35.4 |
| Madina | - | 8 | 27 | 2 | 4 | 1 | 1 | 43 | 5.4 |
| Makkah | - | 10 | 79 | 14 | 12 | - | 7 | 122 | 15.3 |
| Najran | - | 3 | 11 | 1 | 2 | - | 2 | 19 | 2.4 |
| Northern Province | - | 1 | 3 | - | - | - | 1 | 5 | 0.6 |
| Qassim | 1 | 2 | 8 | 1 | 1 | - | 1 | 14 | 1.8 |
| Riyadh | 1 | 20 | 77 | 6 | 23 | - | 3 | 130 | 16.4 |
| Tabuk | - | 1 | 9 | 1 | 4 | - | - | 15 | 1.9 |
| Total KSA | 10 | 159 | 414 | 65 | 110 | 4 | 32 | 794 | 100 |
35.4% of these oral cancers were referred from one province - Jizan. The use of shamma in KSA is most commonly practiced in Jizan province, although not limited to this province only.
Source: Allard WF. et al. Smokeless tobacco (shamma) and oral cancer in Saudi Arabia. Community Dent Oral Epidemiol 1999; 27: 398-405.
| Age and Sex distribution of 72 patients* with oral lichen planus from Gizan** region (1982-1987) | ||||||
|---|---|---|---|---|---|---|
| Age groups | Men | Women | Total | |||
| n | % | n | % | n | % | |
| 20-29 | 1 | 1.3 | 3 | 4.2 | 4 | 5.5 |
| 30-39 | 8 | 8.3 | 5 | 6.9 | 11 | 15.2 |
| 40-49 | 15 | 20.8 | 7 | 9.7 | 22 | 30.5 |
| 50-59 | 14 | 19.4 | 5 | 6.9 | 19 | 26.3 |
| 60-69 | 2 | 2.7 | 9 | 12.5 | 11 | 15.2 |
| 70 + | 2 | 2.7 | 3 | 4.2 | 5 | 6.9 |
| Total | 40 | 55.6 | 32 | 44.4 | 72 | 100 |
* The study material comprised of 4277 Saudi patients aged 18-72 yr (63% males and 37% females)
seen in the dental department of King Fahd Central Hospital between 1982-1987.
** The population of Gizan is one sixth of the total population of Saudi Arabia
Source: Salem G. Oral Lichen planus among 4277 patients from Gizan, Saudi Arabia.
Community Dent Oral Epidemiol 1989; 17: 322-324.
| Characteristics of 72 patients with oral lichen planus from Gizan region (1982-1987) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Clinical Form | Patients | Sex | Age (yr) mean | Associated skin lesion* | Tobacco habits | ||||
| n | % | M | F | n | % | n | % | ||
| Reticular | 18 | 25.0 | 10 | 8 | 34.2 | 2 | 2.8 | 8 | 11.1 |
| Hypertropic | 4 | 5.5 | 4 | 0 | 46.5 | 0 | 0 | 4 | 5.5 |
| Atropic | 22 | 30.5 | 10 | 12 | 56.0 | 1 | 1.4 | 10 | 13.9 |
| Erosive | 28 | 38.8 | 15 | 12 | 51.0 | 0 | 0 | 10 | 13.9 |
| Total | 72 | 100 | 40 | 32 | 49.2 | 3 | 4.2 | 32 | 44.4 |
Source: Salem G. Oral Lichen planus among 4277 patients from Gizan, Saudi Arabia.
Community Dent Oral Epidemiol 1989; 17: 322-324.
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