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Chronic mechanical irritation enhances the effect of tobacco and alcohol on the risk of oral squamous cell carcinoma: a case-control study in Argentina

Clinical Oral Investigations (2022)Cite this article

Abstract

Objectives

Oral squamous cell carcinoma (OSCC) is a multifactorial disease. The individual effect of each risk factor for OSCC may be conditioned by the frequency of other factors. The objective of this study was to identify the association between chronic mechanical irritation (CMI) and OSCC and to analyse the influence of CMI on other important risk factors for OSCC.

Materials and methods

A prospective and age/sex-matched case-control study was performed in two institutions from Argentina between 2009 and 2019, with consecutive and newly diagnosed OSCC. The frequencies of tobacco, alcohol, and CMI were analysed using conditional logistic regression. Cumulative tobacco consumption and the presence of CMI were analysed using the Mann-Whitney test.

Results

CMI and OSCC were associated with an OR of 7.02 (95% CI 3.57–13.78, p < 0.001). The combination of CMI and alcohol demonstrated the highest risk of OSCC (OR 53.83, CI 95% 8.04–360, p < 0.0001), followed by the combination of CMI, tobacco, and alcohol (OR 48.06, CI 95% 8.47–272, p < 0.0001). The combination of CMI and tobacco was also significant (OR 5.61, CI 95% 1.07–29.54, p = 0.042). Patients with CMI developed OSCC with less cumulative tobacco use compared with those without CMI.

Conclusion

CMI is an independent risk factor for OSCC, and it could act as a risk modifier among tobacco and alcohol users having an enhancing effect.

Clinical relevance

Elimination of CMI could decrease the risk of OSCC.

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Authors and Affiliations

  1. Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Av. Haya de la Torre s/n, Ciudad Universitaria, 5000, Córdoba, Argentina

    Eduardo David Piemonte, Jerónimo Pablo Lazos, Gerardo Marcelo Gilligan & René Luis Panico

  2. Oral Medicine Service, Hospital Alemán, Buenos Aires, Argentina

    Laura Cecilia Werner

  3. National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan

    Yi-Hsin Yang

  4. Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London & WHO Collaborating Centre for Oral Cancer, London, UK

    Saman Warnakulasuriya

Authors
  1. Eduardo David Piemonte
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  2. Jerónimo Pablo Lazos
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  3. Gerardo Marcelo Gilligan
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  4. René Luis Panico
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  5. Laura Cecilia Werner
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  6. Yi-Hsin Yang
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  7. Saman Warnakulasuriya
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Contributions

Conceptualization: EDP and SW. Methodology: EDP and SW. Formal analysis and investigation: EDP, JPL, GMG, RLP, LCW, Y-HY, and SW. Writing — original draft preparation: EDP, JPL, GMG, and SW. Writing — review and editing: EDP, JPL, GMG, RLP, LCW, Y-HY, and SW. Funding acquisition: EDP and GMG. Resources: EDP, JPL, and GMG. Supervision: SW.

Corresponding author

Correspondence to Eduardo David Piemonte.

Ethics declarations

Ethics approval

This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the Council of Ethical Evaluation of Health Research under the Ministry of Health of the Province of Córdoba (N° 1378), by the Institutional Committee of Ethics in Health Research of the Faculty of Dentistry of the University of Córdoba (11T/2016), and by the Research Ethics Committee of the Hospital Alemán, Buenos Aires, Argentina (registration code 3674).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Piemonte, E.D., Lazos, J.P., Gilligan, G.M. et al. Chronic mechanical irritation enhances the effect of tobacco and alcohol on the risk of oral squamous cell carcinoma: a case-control study in Argentina. Clin Oral Invest (2022). https://doi.org/10.1007/s00784-022-04584-w

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  • DOI: https://doi.org/10.1007/s00784-022-04584-w

Keywords

  • Tobacco
  • Alcohol
  • Chronic mechanical irritation
  • Oral squamous cell carcinoma
  • Risk factors
  • Case-control study