Oral Squamous Cell Carcinoma, Socioeconomic Status and History of Exposure to Alcohol and Tobacco

Oral squamous cell carcinoma, traditionally a disease of elderly men with a history of chronic exposure to the carcinogenic effects of tobacco and alcohol, is presently being more frequently diagnosed both in a younger patient population and in those not exposed to these carcinogenic substances. At our center, most patients with oral squamous cell carcinoma are not involved in the use of tobacco or alcoholic beverages and are mainly of a low socioeconomic class. This hospital-based case-control study was designed to assess if the risk of developing intraoral squamous cell carcinoma in Ibadan, Nigeria, was associated with the use of tobacco, alcohol, or socioeconomic status. Medical records of patients with histological diagnosis of squamous cell carcinoma of the oral cavity at the University College Hospital, Ibadan, between January 1990 and December 2008 were analyzed. Only 26% of patients gave a positive history of exposure to tobacco, alcohol, or both; of this number, 20.3% used tobacco, while 18.8% consumed alcohol and 13% used both. Although 24.6% of the cases were of high socioeconomic class, there was no significant difference in the distribution of oral cancer patients in the 2 socioeconomic classes. This study revealed an important deviation from expected amongst the oral squamous cell carcinoma patients diagnosed at Ibadan, thus raising the possibility of a different etiology for oral cancer in our population and the need for research focused on identifying possible risk factors.