Smoking and chewing habits of oral cancer patients in the Solomon Islands.

A 5-year retrospective study (1994-97 and 1999) on the prevalence of oral cancer was conducted using patients' records at the Dental Department in the Solomon Islands, National Referral Hospital. The aim of the study was to investigate the relationship between smoking and betel nut chewing in patients with oral cancer. Relevant information regarding patient's smoking and betel nut chewing, site of oral cancer and personal history were extracted from patient's dental records and analyzed. There were 48 cases of oral cancer reported at the hospital over the 5-year period. Males aged 45 years and over were mostly affected with the distribution showing 31.5% of the cases from Malaita, 20.8% from Temotu and 14.6% from the Western Provinces. Ninety percent (90%) of the oral cancer patients practice both smoking and betel nut chewing, compared to those who only practice one habit and this was highly significant (p<0.001). Chewing of high levels of betel quid per day (>5) showed statistical significance (p<0.001) for oral cancer patients (83%) compared to those individuals (17%) who chewed lesser (<5) betel quid. About 62% of these patients smoked cigarette rolls and tobacco stick rolls. However, there was no significance in the relationship of oral cancer and those individuals who smoke (p > 0.05). Buccal mucosa (3 1 %) and buccal mucosa+adjacent comer of the mouth (25%) are the most common affected site in the oral cavity. This study has shown that the combinations of tobacco smoking and chewing of betel quid are the main risk factors for oral cancer. Therefore, these factors are to be emphasized in the public and preventive education of communities in the Solomon Islands.