Published online Jul 20, 2022. doi: 10.5662/wjm.v12.i4.293
Peer-review started: February 16, 2022
First decision: April 12, 2022
Revised: April 19, 2022
Accepted: July 8, 2022
Article in press: July 8, 2022
Published online: July 20, 2022
Processing time: 154 Days and 1.7 Hours
World Health Organization (WHO) assessment estimated that by 2020 tobacco-related death may exceed 1.5 million annually or 13% of all deaths in India. Tobacco consumption and smoking are seen in different socioeconomic groups, and this adverse habit is spread over urban and rural areas, giving rise to precancerous lesions and conditions. Prevalence of various oral lesions and conditions in India are varying in different studies. Numerous studies have been conducted throughout India to determine the prevalence of precancerous lesions and conditions.
Tobacco consumption and smoking are seen in different socioeconomic groups, and this adverse habit is spread over urban and rural areas, giving rise to precancerous lesions and conditions. Different studies vary the prevalence of various oral lesions and conditions in India. So we were interested in compiling the data of precancerous lesions and conditions.
The objective of the present systematic literature review was to investigate a pooled estimate, which gave the prevalence of precancerous lesions and conditions among tobacco users in India population.
Systematic search was conducted for population or community-based observational epidemiological studies in PubMed, EMBASE, Web of Science, IndMED, Google Scholar, reports of the WHO South-East Asia Region, MOHFW India reports, Science Citation Index, WHO Index Medicus of the South-East Asian Region, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Open Grey from the earliest available up to 31st January 2022. The effect size was calculated for the prevalence of precancerous lesions and conditions.
One hundred sixty-two estimates from 130 studies yielded 52 high, 71 moderate, and seven low-quality studies from 823845. Point estimate based on cross-sectional studies for leukoplakia was 4.3% (95%CI: 4.0-4.6), oral submucous fibrosis was 2.7% (95%CI: 2.5-3.0), palatal lesions in reverse smokers and nicotine palatine were 5.8% (95%CI: 4.4-7.2), and Erythroplakia was 1.2% (95%CI: 0.7-1.7), and lichen planus was 1.1% (95%CI: 0.9-1.2). Amongst hospital-based studies, the pooled prevalence for Leukoplakia was 6.7% (95%CI: 6.0-7.3), oral submucous fibrosis was 4.5% (95%CI: 4.2-4.9), lichen planus was 7.5% (95%CI: 5.3-9.6), and erythroplakia was 2.5% (95%CI: 0.4-4.5), and palatal lesions in reverse smokers and nicotine palatini were 11.5% (95%CI: 8.0-15.0). The meta-analysis indicates that hospital-based studies have a higher effect size of 6.7% than community-based studies, which show an effect size of 4.3%. Based on the present meta-analysis, the prevalence of leukoplakia is around 5%-6%. The prevalence of erythroplakia in community-based studies is lower (1.2%) than in hospital-based studies.
Precancerous lesions and conditions are prevailing problems among the Indian population. It is mainly due to tobacco use, the smokeless form of tobacco. The meta-analysis indicates that hospital-based studies have a higher effect size of 6.7% than community-based studies. Patients who have already developed this condition may be advised to reduce their exposure to the risk factor to prevent the condition from progressing further.
Knowing these risk factors paved the way for more effective prevention of these pre-cancerous conditions. Patients who have already developed this condition may be advised to reduce their exposure to this risk factor to prevent the disorder from progressing further. Early intervention is essential to effective prevention. Thus, necessary efforts should be implemented.