Evaluation & Comparison of Risk Factors & Clinicopathological Characteristics of Oral Squamous Cell Carcinoma (OSCC) in Patients Above and Below 40 Years of Age: A Population-Based Comparative Study

Abstract Objectives To assess and compare the risk factors, demographic patterns, and clinicopathological characteristics of oral squamous cell carcinoma (OSCC) in patients aged ≤ 40 years and > 40 years. Materials and Methods A retrospective descriptive study was conducted using hospital records of OSCC patients from 2015 to 2019 at a tertiary center in South India. A total of 1153 records were screened, and 882 patients with complete data were included. Demographic details, oral risk habits, lesion characteristics, tumour stage, grade, comorbidities, and treatment modalities were analysed. Statistical comparisons between age groups were performed using Chi-square and t-tests. Results Of the 882 patients, 105 (11.9%) were ≤ 40 years and 777 (88.1%) were > 40 years. A male predominance was observed in both groups. Smokeless tobacco was the most prevalent risk habit across age groups. Younger patients showed a significant predilection for tongue lesions, whereas older patients most commonly presented with buccal mucosa involvement. No significant differences were found between age groups in OSCC stage, histopathological grade, treatment modalities, or recurrence rates. Comorbidities were significantly more common in older individuals. Conclusion Younger patients demonstrated unique lesion distribution patterns despite sharing similar risk profiles with older adults. The findings highlight the growing burden of OSCC among younger individuals and emphasize the need for early detection strategies and targeted preventative efforts, particularly focused on tobacco and areca nut cessation.