Oral cancer epidemiology in relation to inter-country disparities in human development in south and Southeast Asia.

OBJECTIVES: South Asia (SA) and Southeast Asia (SEA) are geographically close; however, discrepancies in oral cancer (OC) epidemiology exist between the two regions. Socioeconomic disparities may influence the OC burden. The aim of this study was to assess the epidemiology of OC and its relationship with the Inequality Adjusted Human Development Index (IHDI) and its components in SA and SEA. METHODS: Cancer data for this ecological study was obtained from GLOBOCAN 2020, while the IHDI was obtained from the Human Development Report 2020. Based on data availability, 14 SA and SEA countries were chosen. Poisson log-weighted regression models were employed to examine IHDI and its components in relation to incidence and mortality. Univariate linear regression models were utilized to determine the association between the mortality-to-incidence ratio (MIR) and the IHDI. RESULTS: Mortality and MIR of OC were negatively correlated with all sub-indices of the IHDI, including education, health and income. However, incidence and mortality of OC were influenced by region and sex. CONCLUSIONS: Higher IHDI countries tended to have lower MIR. SA and males showed higher incidence and mortality. Reducing intra-country inequalities in development may be a pragmatic approach to enhancing the OC burden and prognosis.

Prevalence of and prognostic factors for Candida superinfection in oral lichen planus and lichenoid reactions: A retrospective cohort study.

BACKGROUND: Oral candidiasis occasionally occurs in patients with oral lichen planus (OLP) or lichenoid reaction (OLR). However, not all patients undergoing corticosteroid therapy develop Candida superinfection. Thus, the identification of prognostic risk factors may help to identify patients at risk of Candida superinfection. METHODS: A retrospective cohort study was conducted to review patients with OLP/OLR who received steroid therapy at a single dental hospital between January 2016 and December 2021. The prevalence of Candida superinfection and prognostic factors were assessed. RESULTS: Eighty-two eligible patients with OLP/OLR were retrospectively reviewed. The overall prevalence of Candida superinfection during the study period was 35.37%; the median time-to-event between initiation of corticosteroid therapy and diagnosis of superinfection was 60 days (interquartile range; 34-296). The ulcerative type of OLP/OLR, number of topical steroid applications, poor oral hygiene, and oral dryness were significantly associated with superinfection (p < 0.05; Fisher's Exact test) and were identified as prognostic factors in univariable risk ratio regression. Multivariable risk ratio regression revealed the ulcerative type of OLP/OLR and number of topical steroid applications were significant prognostic factors for Candida superinfection in patients with OLP/OLR. CONCLUSION: Candida superinfection occurs in approximately one-third of patients with OLP/OLR undergoing corticosteroid therapy. Patients with OLP/OLR should be closely monitored in the first 2 months (60 days; median time to infection) after steroid prescription. The ulcerative type of OLP/OLR and a higher number of topical steroid applications per day may represent prognostic factors to identify patients at risk of Candida superinfection.

Knowledge and Health Belief Attitudes of Oral Cancer and Its Screening Among At-Risk Southern Thai Muslims.

Oral cancer is one of the leading cancers in Thailand; southern Thai Muslims seem to have a longer delay in attending treatment for oral cancer than Buddhists in the same area. Visual screenings of high-risk populations have been suggested to be an effective prevention method. This study assessed oral cancer knowledge and belief attitudes influencing oral cancer screening in Thai Muslim high-risk groups. Twelve semi-structured in-depth interviews and the focus group discussion were conducted based on the health belief model. Stratified purposeful sampling was used to recruit the participants. Inclusion criteria were those who practiced the risk habits for oral cancer and were 40 years of age or older, smokers (20+ cigarettes per day for at least 20 years) and/or betel quid chewers (10+ times per day for at least 10 years). Participants lacked knowledge about oral cancer in terms of signs and symptoms and predisposing factors. This influenced misleading belief attitudes concerning susceptibility of oral cancer, barriers, and their self-efficacy to have oral cancer screening examinations. Betel quid chewing was not regarded as a risk habit but as having a protective role against the disease. Perceived susceptibility was also seen by some to be dependent upon Allah's will. Traditional medication was mentioned as a preferred alternative to modern treatment. The latter was believed by some to be the cause of death for cancer patients. Interventions to promote oral cancer knowledge and right belief attitudes for oral cancer screening are clearly indicated.