Dalirsani Zohreh, Ghazi Ala, Pakfetrat Atessa, Jamali Jamshid, Foroughi Zeinab, Mirzaei Mohammad
Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Addict Health. 2025 Jan;17:1522. doi: 10.34172/ahj.1522. Epub 2025 May 10.
Many studies have examined the association between smokeless tobacco and the risk of oral cancer. In South and Southeastern Asia, the use of smokeless tobacco, which increases the risk of oral cancer, is very common. The aim of this study is to provide a comprehensive review of studies conducted and published in a period of ten years to provide a more accurate assessment of the association between smokeless tobacco and oral cancer.
An electronic search in six databases (PubMed, Scopus, Embase, Web of Science, ProQuest, and Cochrane Library) was conducted using keywords equivalent to oral cancer and smokeless tobacco. After selecting the articles according to the inclusion and exclusion criteria, a total of 30 prospective cohort and case-control studies from 2010 to 2020, which investigated the association of smokeless tobacco with oral cancer, were examined. The articles were qualitatively assessed using the Newcastle Ottawa Quality Assessment scale checklist. Then, study design (study type, setting, and duration of data collection), sample population (number, gender, and age), cancer type, smokeless tobacco type, effect size, and confounder adjustment were extracted from the studies.
Five studies examined smokeless tobacco and chewing tobacco, and 25 studies reported and evaluated the type of smokeless tobacco, most of which were related to betel quid and supari. While the results of 21 studies revealed a positive and significant relationship between oral cancer and smokeless tobacco use (OR: 0.67-149.5), seven studies did not find a significant correlation.
This systematic review confirms the positive and significant association between non-smoking tobacco use and the risk of oral cancer.
许多研究已探讨无烟烟草与口腔癌风险之间的关联。在南亚和东南亚，增加口腔癌风险的无烟烟草使用非常普遍。本研究的目的是对十年期间开展并发表的研究进行全面综述，以便更准确地评估无烟烟草与口腔癌之间的关联。
使用与口腔癌和无烟烟草等效的关键词在六个数据库（PubMed、Scopus、Embase、Web of Science、ProQuest和Cochrane图书馆）中进行电子检索。根据纳入和排除标准筛选文章后，共审查了2010年至2020年期间30项调查无烟烟草与口腔癌关联的前瞻性队列研究和病例对照研究。使用纽卡斯尔渥太华质量评估量表清单对文章进行定性评估。然后，从研究中提取研究设计（研究类型、地点和数据收集持续时间）、样本人群（数量、性别和年龄）、癌症类型、无烟烟草类型、效应大小和混杂因素调整。
五项研究考察了无烟烟草和咀嚼烟草，25项研究报告并评估了无烟烟草类型，其中大部分与槟榔和蒌叶有关。虽然21项研究的结果显示口腔癌与无烟烟草使用之间存在正相关且具有统计学意义（比值比：0.67 - 149.5），但七项研究未发现显著相关性。
本系统评价证实了使用无烟烟草与口腔癌风险之间存在正相关且具有统计学意义。
