Polymorphisms in tobacco metabolism and DNA repair genes modulate oral precancer and cancer risk.

The highest rates of oral squamous cell carcinomas are observed in south Asia, particularly in India, where complex forms of tobacco and alcohol exposures exist. Genetic polymorphisms contribute significantly to observed differences in cancer susceptibility. We examined the association of 13 variants in eight genes (rs4646903, rs2031920, rs3813867, GSTM1 null, GSTT1 null, rs1695, rs1138272, rs1799782, rs25487, rs1799791, rs1799793, rs13181 and rs1052133) involved in various stages of tobacco and alcohol metabolism and the risk of leukoplakia and oral cancer (OC) in a case-control study involving 219 oral leukoplakia, 665 OC and 802 age, sex and habit-matched controls. GSTT1 null and rs1695 were inversely associated with oral leukoplakia while GSTM1 null, GSTT1 null, rs2031920, rs3813867 (CYP2E1), and rs13181 were associated with OC. We report that genetic variants associated with premalignant and malignant conditions of the oral cavity differ. The associations appeared to be consistent among smokeless tobacco users, a characteristic risk factor in these parts.