BACKGROUND: Prevalence of oral cancer is high in Sudan and the disease is attributed to N-nitrosamine rich oral snuff consumption. MATERIALS AND METHODS: As part of the development of a screening procedure for oral cancer and precancer, exfoliative cytology (EFC) was applied to a retrospective cohort to assess the presence and severity of oral epithelial atypia (ET) in 300 subjects (100 toombak dippers; 100 cigarette smokers; 100 non-tobacco users) without prior knowledge of the subjects' tobacco exposure. Five patients with oral squamous cell carcinoma (OSCC) were included as internal controls. RESULTS: ET was ascertained in 29 subjects and could not be ascertained in the remaining 271. Among the 29 subjects with ET, there were 11 (38%) toombak dippers, 14 (48%) cigarette smokers and 4 (14%) non-tobacco users. Among the 271 subjects without ET, there were 89 (33%) toombak dippers, 86 (32%) cigarette smokers and 96 (35%) non-tobacco users. ET was found in all the 5 control cases with OSCC. For the ET among toombak dippers and cigarette smokers, adjusted OR and the 95% CI were found to be 3 (0.91-9.7) and 4 (1.2-12.3), respectively. CONCLUSION: In view of these findings, we propose the use of EFC for detection and assessment of oral ET.
BACKGROUND: Prevalence of oral cancer is high in Sudan and the disease is attributed to N-nitrosamine rich oral snuff consumption. MATERIALS AND METHODS: As part of the development of a screening procedure for oral cancer and precancer, exfoliative cytology (EFC) was applied to a retrospective cohort to assess the presence and severity of oral epithelial atypia (ET) in 300 subjects (100 toombak dippers; 100 cigarette smokers; 100 non-tobacco users) without prior knowledge of the subjects' tobacco exposure. Five patients with oral squamous cell carcinoma (OSCC) were included as internal controls. RESULTS:ET was ascertained in 29 subjects and could not be ascertained in the remaining 271. Among the 29 subjects with ET, there were 11 (38%) toombak dippers, 14 (48%) cigarette smokers and 4 (14%) non-tobacco users. Among the 271 subjects without ET, there were 89 (33%) toombak dippers, 86 (32%) cigarette smokers and 96 (35%) non-tobacco users. ET was found in all the 5 control cases with OSCC. For the ET among toombak dippers and cigarette smokers, adjusted OR and the 95% CI were found to be 3 (0.91-9.7) and 4 (1.2-12.3), respectively. CONCLUSION: In view of these findings, we propose the use of EFC for detection and assessment of oral ET.