Oral Cancer Disease among the Poor: A Sri Lankan Context
Abstract
:1. Introduction
1.1. Causes of OC and OPMD in Sri Lanka
1.2. Undernourishment in the Lower/Middle-Income Group
1.3. OC as a Public Health Concern in Sri Lanka
1.4. Socioeconomic Impact of OC and Reasons for OC among Low/Middle-Income Groups
1.5. OC and OPMD Awareness among Low- and Middle-Income Groups of Sri Lanka
1.6. Future Recommendations
- Cruciferous Vegetables: Vegetables like cabbage, cauliflower, broccoli, and kale are rich in vitamins, minerals, and antioxidants that have been linked to a reduced risk of certain cancers.
- Tomatoes: Tomatoes contain lycopene, a powerful antioxidant that has been associated with a lower risk of prostate cancer. Cooking tomatoes increases the bioavailability of lycopene.
- Garlic: Garlic contains organosulfur compounds that have been shown to have cancer-fighting properties, particularly against stomach and colorectal cancers.
- Turmeric: Curcumin, the active compound in turmeric, has anti-inflammatory and antioxidant properties that may help in preventing certain types of cancer.
- Beans and Lentils: Legumes are high in fiber, which can help regulate blood sugar levels and promote a healthy digestive system. Some studies have suggested that they may also have a protective effect against certain cancers.
- Green Tea: Green tea contains catechins, which are antioxidants that have been associated with a reduced risk of certain cancers.
- Whole Grains: Whole grains like brown rice, whole wheat, and oats are rich in fiber, vitamins, and minerals, and have been linked to a decreased risk of colorectal cancer.
- Onions: Onions, like garlic, contain organosulfur compounds that may help in cancer prevention, especially against stomach and colorectal cancers.
- Citrus Fruits: Citrus fruits such as oranges, lemons, and grapefruits are rich in vitamin C and other antioxidants, which may help protect against certain types of cancer.
2. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Author | Year of Publication | Inclusion and Exclusion Criteria | Research Objectives | Study Design | Sample Characteristics | Study Instrument | Conclusion |
---|---|---|---|---|---|---|---|
Perera et al. [24] | 2005 | Inclusion criteria were residents of southern district of Sri Lanka | To identify smoking prevalence rates by gender and age and respondents’ attitudes toward smoking and possible associations between alcohol use and smoking. | Descriptive cross-sectional survey | Cluster sampling method was used to select respondents. Considering the time and resources, authors chose to survey nearly 1600 adults in the population. | Self-administered anonymous questionnaire | Higher prevalence rates for tobacco were observed among less educated, middle-aged men who were from underprivileged families. Alcohol use seems to be positively associated with smoking. |
Ariyawardana and Vithanaarachchi [59] | 2005 | Inclusion criteria were outpatients attending the Dental Teaching Hospital, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka | To investigate OC and precancer awareness among patients undergoing dental treatment at a university dental hospital. | Questionnaire-type survey | Subjects (n = 410) were randomly chosen | Self-administered questionnaire | According to the results of this survey, out patients were adequately informed about OC. However, precancer awareness was relatively poor. In comparison to betel chewing, knowledge of the causal links between cigarette smoking and alcohol usage was minimal. |
Ariyawardana et al. [21] | 2007 | Inclusion criteria were residents in or attached to a nearby estate of the central province, Sri Lanka. | To obtain demographic data on risk factors associated with OC and OPMD and to conduct and report the outcome of an oral mucosal examination on tea estate laborers in Sri Lanka. | - | 12,716 tea laborers over the age of 15 years employed by 73 tea estates in central Sri Lanka by estate medical officers | Questionnaires and oral examination | The prevalence of oral pre-cancer in tea estate laborers was higher than estimates reported in previous studies. |
de Silva et al. [22] | 2009 | Inclusion criteria were males residents of Colombo and Polonnaruwa over 18 years of age | To investigate the prevalence and consumption of tobacco and alcohol among males in the Colombo and Polonnaruwa districts | A cross-sectional study based on multistage cluster sampling | The sample consisted of males over 18 years. There were 1318 from the Colombo District and 1366 from the Polonnaruwa District. | Interviewer-administered questionnaire | According to the mean alcohol intake and the number of people who consumed spirits on a regular basis, high-risk alcohol use was prevalent, particularly in urban regions. Smoking prevalence was substantially lower than in many Asian countries, but comparable to Western Europe. |
Amarasinghe et al. [28] | 2010 | Inclusion criteria were residents of Sabaragamuwa province. | To investigate the level of public awareness of OC and OPMD and of risk factors | A cross-sectional community-based survey | A total of 1029 subjects were selected. | Interviewer-administered questionnaire | Knowledge of OC, OPMD and their associated risk factors was poor among this population, indicating an urgent need to implement public health education and promotion strategies. |
Amarasinghe et al. [26] | 2013 | Inclusion criteria were residents of Sabaragamuwa province. | To investigated the association of OPMD (and leukoplakia as a subgroup) with the consumption of fruits, vegetables, chillis and tea. | A cross-sectional community survey | A total of 1029 subjects were selected by a multistage, stratified and clustered sampling technique. | Interviewer-administered questionnaire | This study reveals the prevalence of malnutrition in this rural population, with relatively low daily consumption of fruits and vegetables. Cancer-preventive characteristics in their diets are limited and overshadowed by known carcinogenic substances associated with betel quid, cigarette, and alcohol usage. |
Alahapperuma and Fernando [58] | 2017 | Inclusion criteria were those who have been diagnosed with oral and pharyngeal cancer within 3 months of the interview date. Mentally handicapped patients and patients who were debilitated and unable to respond were excluded. | To identify patient-linked delays between the time of noticing the symptoms and definitive diagnosis and its association with the stage at diagnosis and socio-demographic factors among oral and pharyngeal carcinoma patients attending the National Cancer Institute, Maharagama. | A hospital-based descriptive cross-sectional study | 351 patients with histologically confirmed carcinoma of the oral cavity and pharynx. | Interviewer-administered questionnaire | Stage at diagnosis was associated with ‘Patient Delay-1’ (p = 0.001) but not with ‘Patient Delay-2’ (p = 0.001). ‘Patient Delay-1’ was significantly associated with education level (p = 0.001) and travel cost (p = 0.048). |
Amarasinghe et al. [10] | 2018 | Inclusion criteria were residents of Sabaragamuwa province. | To determine the prevalence of OPMD and of lifestyle factors among the population in the Sabaragamuwa Province of Sri Lanka. | A cross-sectional community based study | A total of 1029 subjects above the age of 30 years | Interviewer-administered questionnaire | This study reveals that in these populations, OPMD and OC risk factors are highly prevalent. For the purpose of preventing OC, a comprehensive approach to manage cigarette, betel nut, and alcohol usage is urgently needed. |
Amarasinghe et al. [54] | 2019 | The study was conducted in selected cancer treatment centers in Sri Lanka. | To estimate the costs of managing patients with OC in Sri Lanka for a 12 month period from diagnosis. | Hospital-based costing study (activity-based costing with cost apportionment and step-down costing approach was used). | Sixty-nine OC patients: 60 were males and 12 had recurrent tumors. | Interviewer-administered questionnaire | Because of the high prevalence of OC in Sri Lanka, the economic expenditures related to these diseases are significant, wreaking havoc on both the healthcare system and individual families, and severely affecting the country’s economy. |
Amarasinghe et al. [29] | 2021 | Inclusion criteria were patients who were seeking care from the Out Patients Department attendees of the Institute of Oral Health, Maharagama, Sri Lanka. Patients who refused to provide relevant information were excluded from the study. | To assess the care seeking pattern and behavior and its associated factors for OPMD among the patients’ attendees and also to evaluate the impact of the existing early detection program for OC. | A hospital based descriptive cross-sectional study | A total number of 110 OPMD/oral cancer patients were recruited. | Interviewer-administered questionnaire | The general public was unaware about OPMD and its risk factors. The fact that incidental findings during dental screening are the primary route of identification of OPMD emphasizes the need of doing opportunistic screening in dental settings. |
Kosgallana et al. [75] | 2023 | Inclusion criteria were OC patients awaiting radiotherapy alone or with chemotherapy at the National Cancer Institute (Apeksha Hospital), Maharagama, Sri Lanka. | To evaluate the OHRQOL and its changes from baseline through the last week of radiotherapy and three months after radiotherapy in patients with OC who underwent this treatment alone or in combination with chemotherapy. | A prospective longitudinal study. | 90 OC patients. | The modified Sinhala version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Oral Health Module (EORTC QLQ-OH15) was used to gather data related to OHRQOL before radiotherapy. | The OHRQOL of oral cancer patients who received radiotherapy alone or in combination with chemotherapy worsened from baseline to the last week of radiotherapy, but subsequently improved three months later. However, three months after radiation, the OHRQOL did not revert to the baseline level. OHRQOL during the final week of radiation was affected by baseline OHRQOL, civil status, and metastatic sites. |
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Senevirathna, K.; Jayasinghe, Y.A.; Jayawickrama, S.M.; Amarasinghe, H.; Jayasinghe, R.D. Oral Cancer Disease among the Poor: A Sri Lankan Context. Oral 2023, 3, 420-436. https://doi.org/10.3390/oral3030034
Senevirathna K, Jayasinghe YA, Jayawickrama SM, Amarasinghe H, Jayasinghe RD. Oral Cancer Disease among the Poor: A Sri Lankan Context. Oral. 2023; 3(3):420-436. https://doi.org/10.3390/oral3030034
Chicago/Turabian StyleSenevirathna, Kalpani, Yovanthi Anurangi Jayasinghe, Shalindu Malshan Jayawickrama, Hemantha Amarasinghe, and Ruwan Duminda Jayasinghe. 2023. "Oral Cancer Disease among the Poor: A Sri Lankan Context" Oral 3, no. 3: 420-436. https://doi.org/10.3390/oral3030034