Prevalence of oral ulcers and its association with addictions in rural population of western Uttar Pradesh and eastern Rajasthan

BACKGROUND Head and neck cancer in Indian perspective predominantly relates to tobacco use. The present study explores the prevalence of oral ulcers and its association with addictions among the population of Uttar Pradesh and Rajasthan, India. METHODOLOGY The screening method in early detection of head and neck cancer is broadly symptom based. 1399 subjects from Uttar Pradesh and Rajasthan were screened by trained personnel between April and June 2015. RESULTS Study findings showed, mouth ulcers and trismus were common symptoms and tobacco chewing and smoking were common addictions. There were statistically significant associations among the symptoms and addictions as well as predominance in rural populations. The majority of smokers (27.1%) belonged to age ≥55 years whereas the tobacco chewers (29.2%) and alcohol abusers (45.8%) in the age group 25-34 years. Also the risk of developing mouth ulcers and trismus in this area are approximately 35 (MRR: 35.7, 95% CI: 15.5-81.9) and nearly eight (MRR: 7.7, 95% CI: 2.2-26.6) times higher respectively in males. However, joint use of smoked and smokeless tobacco increases nearly three times more risk of either mouth ulcers or trismus. CONCLUSION Male individuals are more exposed to certain addictions such as tobacco (smoked and smokeless) and alcohol. The prevalence of oral ulcers is primarily associated with the addictions. Therefore, these persons are more at risk of further developing head neck cancer. A large level community screening and awareness are required especially among the rural population of India