Individual and Integrated Effects of Potential Risk Factors for Oral Squamous Cell Carcinoma: A Hospital-Based Case- Control Study in Jazan, Saudi Arabia

Document Type : Research Articles


1 Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Prince Mohammed Bin Nasser Hospital, Jazan, Saudi Arabia.

2 Department of Otorhinolaryngology-Head and Neck Surgery, Prince Mohammed Bin Nasser Hospital, Jazan, Saudi Arabia.

3 Department of Dental Public Health, College of Dentistry, Jazan University, Jazan, Saudi Arabia.


Background: Oral cancer is the sixth most common cancer in the world, with a high prevalence reported in Jazan
province of Saudi Arabia. The objectives of this study were to check individual and integrated effects of potential risk
factors for oral squamous cell carcinoma. Materials and methods: A case control study was designed with a sample
of 210 subjects, in which histopathologically confirmed incident cases (n=70) and controls (n=140) matched for age,
gender and referral route, were recruited. Differences in exposure to potential risk factors between cases and controls
were assessed using chi-square and McNemar analyses. A logistic regression model with interactions was applied to check
individual and integrated effects. Results: Mean age of the sample was 55 years (+ 20 years). Shammah (O.R = 33.01;
C.I = 3.22 – 39.88), shisha (O.R = 3.96; C.I = 0.24 – 63.38), and cigarette (O.R = 1.58; C.I = 0.13, 2.50) consumption
was significantly associated (P<0.05) with oral squamous cell carcinoma development. In contrast, Khat chewing (O.R
= 0.67; C.I = 0.19-2.36) was without significant effect. An increase in odds ratios was observed when combinations
of shammah and shisha (O.R = 35.03; C.I = 11.50-65.66), shisha and cigarettes (O.R = 10.52; C.I = 1.03 – 33.90) or
shamma and cigarettes (O.R = 10.10; C.I = 0.50 - 20.40) were used. Conclusion: Combined exposure to risk-factors
has serious implications and policies on oral cancer prevention should be designed with attention to this aspect.


Main Subjects

Volume 19, Issue 3
March 2018
Pages 791-796
  • Receive Date: 07 October 2017
  • Revise Date: 02 December 2017
  • Accept Date: 13 February 2018
  • First Publish Date: 01 March 2018