Abstract
Oral cancer with incidence (10.2%) and mortality (9.3%) ranks as second most prevalent cancers in India. Oral cancer diagnosis at early stages through the detection of oral potentially malignant disorders (OPMDs) can lead to the prevention and reduction of mortality associated with oral cancer. The objective of the study was to estimate the prevalence and the determinants of OPMDs in Jodhpur, Rajasthan. A cross-sectional study was conducted in six blocks of Jodhpur, Rajasthan. The trained Community Health Officers (CHOs) of Ayushman Arogya Mandir (erstwhile Health and Wellness centers) performed an Oral Visual Examination (OVE) to screen the participants for OPMDs. The inclusion criteria comprised men and women aged 30 years or above or aged between 18 and 29 years with tobacco and/or alcohol consumption habits, visiting Ayushman Arogya Mandir. The association of the OPMD with socio-behavioral risk factors was determined through a bivariate chi-square test and multivariate-binary logistic regression analysis. The overall prevalence of OPMD was found to be 14.84%. The prevalence of leukoplakia (8.61%) was the highest, followed by oral submucous fibrosis (4.78%) and erythroplakia (2.87%). OPMD was significantly higher in lower socioeconomic status (SES). Smokeless tobacco consumption [AOR-8.751(1.500-51.046)], smoking [AOR-20.827 (2.204-196.832], and alcohol consumption [AOR-50.806 (3.617-713.687)] were significantly associated with OPMD. The synergistic effect of smokeless tobacco consumption, smoking, and alcohol consumption on OPMD was observed [AOR-26.222 (2.83-243.48)]. The mean duration and frequency per day of smokeless tobacco consumption and smoking were significantly higher in OPMD. We also found that oral cavity symptoms were strongly associated with OPMD, particularly persistent mouth ulcers and repeated biting injuries due to sharp teeth and dentures. To conclude, the study identified a high prevalence of OPMDs (14.84%) in Jodhpur, with leukoplakia being the most common OPMD. There was a significantly higher prevalence of OPMD in individuals from lower SES. The key modifiable risk factors, including smokeless tobacco use, smoking, and alcohol consumption, were strongly associated with OPMDs, with a notable synergistic effect observed when these behaviors coexisted. Additionally, oral cavity symptoms such as persistent mouth ulcers and repeated biting injuries due to sharp teeth and dentures were found to be determinants of OPMD. The study findings emphasize the need for targeted interventions addressing socio-behavioral risk factors to reduce the burden of OPMDs and prevent the progression to oral cancer.