Molecular and Lifestyle Determinants of Oral Squamous Cell Carcinoma in Bangladesh: Dietary Patterns Independent of HPV and TERT Promoter Mutations

Liza, Rokhsana Akter; Raheem, Enayetur; Akter, Sonia; Hasan, Md. Nadimul; Jamil, Ami Hasan; Thufayal, Abdullah Al; Alam, Md. Morshedul; Islam, Ashekul; Karim, M. Rezaul

doi:10.31557/APJCP.2026.27.6.2259

Molecular and Lifestyle Determinants of Oral Squamous Cell Carcinoma in Bangladesh: Dietary Patterns Independent of HPV and TERT Promoter Mutations

Document Type : Research Articles

Authors

¹ Laboratory of Cancer Biology, Department of Biotechnology and Genetic Engineering, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh.

² Biomedical Research Foundation, Dhaka 1212, Bangladesh.

³ National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh.

⁴ Department of Biochemistry and Microbiology, North South University, Dhaka 1229, Bangladesh.

⁵ Department of Biochemistry and Molecular Biology, Mawlana Bhashani Science and Technology University, Tangail 1902, Bangladesh.

10.31557/APJCP.2026.27.6.2259

Abstract

Background: Oral squamous cell carcinoma (OSCC) is the sixth most prevalent cancer globally and constitutes a major public health burden in Bangladesh, with approximately 7.5% of all cancer-related deaths. Although tobacco and betel-quid use are recognized risk factors, dietary patterns may also contribute to OSCC development. Objective: This study investigated the association of lifestyle and dietary factors with OSCC in Bangladeshi patients and explored the potential involvement of TERT promoter mutations and human papillomavirus (HPV) infection. Methods: A hospital-based, case–control study was conducted involving 47 histopathologically confirmed OSCC patients and 100 age- and sex-matched healthy controls without cancer or chronic illness. Sociodemographic, lifestyle, and dietary data were collected through a structured questionnaire. Tumor DNA was analyzed for TERT promoter mutations and HPV DNA using PCR and Sanger sequencing. Statistical analyses were performed using multivariable logistic regression to identify significant associations. Results: Excessive betel-quid chewing was strongly associated with OSCC (p < 0.01). Among 39 sequenced OSCC samples, 25 single-nucleotide polymorphisms (SNPs) at position –245 (A>G) and one hotspot mutation at position –124 (G>A) of the TERT promoter were identified substantially lower than frequencies reported in other populations. No HPV DNA was detected in any sample. Certain dietary patterns such as low fruit and vegetable intake and high consumption of betel quid were linked to increased OSCC risk. Conclusion: Our findings suggest that, in Bangladeshi patients, specific dietary and lifestyle factors, rather than HPV infection or TERT promoter mutations, contribute significantly to OSCC development. Targeted public health strategies emphasizing nutritional awareness and cessation of betel-quid use are recommended.

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