Study of regional habits influencing Pharyngeal Cancers – Tobacco in various forms with or without Alcohol

The present study was a case control study on pharyngeal cancers and the habits related to it which was carried out in our Dept of ENT, using 30 cases and 90 hospital based controls during a 2 years study period. The various habits of the patients based on the type of tobacco, alcohol intake pan chewing, dietary habits like regular use of salted or smoked fish were studied. We investigated the effects on risk in males and females of tobacco smoking, drinking alcohol, non smoke tobacco use - pan (betel nut)-tobacco chewing and dietary habits. Males were affected. predominantly with 9:1 ratio, more in above 60 age group(in 50%) .More than 50% cases were literate and maintained oral hygiene. Majority of cases were dwelling in rural areas and were manual labourers indulging in various varieties of daily wage works by occupation. More than 50 % came from very poor socioeconomic status . 93% cases showed tobacco smoking history, beedi was the commonly used type with >30 years duration in 76% cases. Alcohol drinking was observed in 76% cases with 20-30 yrs duration in majority cases. Indian made foreign liquors were used in all patients. Among 56% non smoke tobacco use cases, 82 % used pan-tobacco(betel quid) chewing with more than 20 years duration. Among the paticnts, more than 50% were oropharyngeal followed by hypopharyngeal and nasopharyngeal cases and histopathologically were squamous cell carcinoma. On interpreting the results, there was significant positive association with risk were observed for beedi smoking (Relative risk-9.661, odds ratio 15.3 and P value 0.0001), alcohol (Relative risk-2.042, odds ratio -2.512 and P value 0.01), Pan tobacco chewing (Relative risk-3.30, odds ratio 5.615 and P value 0.001), and insignificant results for regular use of salted smoked fish in diet (Relative risk-1 458, odds ratiol.66 and P value 0.59). Although our study has several limitations inherent to case control studies, and less sample size, advantages are heterogeneity of distribution of exposures, a detailed assessment of lifestyle habits for both groups of cases and controls. Thus, for purposes of public health education, discouragement of the tobacco, alcohol and pan chewing habits should take priority, although there is a substantial residual benefit to be gained from reductions in the other habits.