Malignant transformation to oral cancer by subtype of oral potentially malignant disorder: A prospective cohort study of Taiwanese nationwide oral cancer screening program

Shu Lin Chuang, Cheng Ping Wang, Mu Kuan Chen, William Wang Yu Su, Chiu Wen Su, Sam Li Sheng Chen, Sherry Yueh Hsia Chiu, Jean Ching Yuan Fann, Amy Ming Fang Yen

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: To elucidate the risk of malignant transformation to invasive oral cancer by subtypes of oral potentially malignant disorders (OPMD) and to examine the independent effects of risk factors, particularly alcohol drinking, by subtype based on a nationwide oral cancer screening program targeting at general population with habits of smoking and/or betel quids chewing. Materials and methods: The total of 8501 subjects diagnosed as different subtypes of OPMDs from the Taiwanese screening program between 2004 and 2009 were followed up over time to ascertain the occurrence of invasive oral cancer. The hazard ratios of malignant transformation were estimated by using Cox proportional hazards regression model. Results: The overall malignant rate (per 1000 person-years) to oral cancer was 8.4 (407 incident cases with an average of 5.7 years of follow-up). The highest rate was noted in exophytic verrucous hyperplasia (33), followed by erythroplakia (11.8), erythroleukoplakia (10.7), oral submucous fibrosis (OSF) (8.6), and leukoplakia (5.4). After adjusting for confounders, exophytic verrucous hyperplasia still had a 5.69 (4.47–7.24) times risk compared with leukoplakia. The corresponding figures for erythroplakia, erythroleukoplakia, and OSF were 2.25 (1.31–3.89), 2.00 (1.13–3.53), and 1.63 (1.29–2.06), respectively. Alcohol drinking elevated the overall risk of malignant transformation by 23% (1–52% and also triggered a higher risk in OSF (aHR = 1.62 (1.06–2.47)). The higher risk attributed to betel quids chewing was noted for exophytic verrucous hyperplasia (aHR = 4.23 (1.55–11.55)). Conclusions: The risk of malignant transformation to oral cancer varied with the subtypes of OPMD and was elevated in OSF and verrucous hyperplasia attributed to alcohol drinking and betel quids, respectively.

Original languageEnglish
Pages (from-to)58-63
Number of pages6
JournalOral Oncology
Volume87
DOIs
Publication statusPublished - Dec 1 2018

Fingerprint

Mouth Neoplasms
Oral Submucous Fibrosis
Early Detection of Cancer
Cohort Studies
Prospective Studies
Hyperplasia
Alcohol Drinking
Leukoplakia
Mastication
Proportional Hazards Models
Habits
Smoking
Population

Keywords

  • Malignant transformation
  • Mass screening
  • Oral cancer
  • Oral potentially malignant disorder

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

Cite this

Malignant transformation to oral cancer by subtype of oral potentially malignant disorder : A prospective cohort study of Taiwanese nationwide oral cancer screening program. / Chuang, Shu Lin; Wang, Cheng Ping; Chen, Mu Kuan; Su, William Wang Yu; Su, Chiu Wen; Chen, Sam Li Sheng; Chiu, Sherry Yueh Hsia; Fann, Jean Ching Yuan; Yen, Amy Ming Fang.

In: Oral Oncology, Vol. 87, 01.12.2018, p. 58-63.

Research output: Contribution to journalArticle

Chuang, Shu Lin ; Wang, Cheng Ping ; Chen, Mu Kuan ; Su, William Wang Yu ; Su, Chiu Wen ; Chen, Sam Li Sheng ; Chiu, Sherry Yueh Hsia ; Fann, Jean Ching Yuan ; Yen, Amy Ming Fang. / Malignant transformation to oral cancer by subtype of oral potentially malignant disorder : A prospective cohort study of Taiwanese nationwide oral cancer screening program. In: Oral Oncology. 2018 ; Vol. 87. pp. 58-63.
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T2 - A prospective cohort study of Taiwanese nationwide oral cancer screening program

AU - Chuang, Shu Lin

AU - Wang, Cheng Ping

AU - Chen, Mu Kuan

AU - Su, William Wang Yu

AU - Su, Chiu Wen

AU - Chen, Sam Li Sheng

AU - Chiu, Sherry Yueh Hsia

AU - Fann, Jean Ching Yuan

AU - Yen, Amy Ming Fang

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N2 - Objectives: To elucidate the risk of malignant transformation to invasive oral cancer by subtypes of oral potentially malignant disorders (OPMD) and to examine the independent effects of risk factors, particularly alcohol drinking, by subtype based on a nationwide oral cancer screening program targeting at general population with habits of smoking and/or betel quids chewing. Materials and methods: The total of 8501 subjects diagnosed as different subtypes of OPMDs from the Taiwanese screening program between 2004 and 2009 were followed up over time to ascertain the occurrence of invasive oral cancer. The hazard ratios of malignant transformation were estimated by using Cox proportional hazards regression model. Results: The overall malignant rate (per 1000 person-years) to oral cancer was 8.4 (407 incident cases with an average of 5.7 years of follow-up). The highest rate was noted in exophytic verrucous hyperplasia (33), followed by erythroplakia (11.8), erythroleukoplakia (10.7), oral submucous fibrosis (OSF) (8.6), and leukoplakia (5.4). After adjusting for confounders, exophytic verrucous hyperplasia still had a 5.69 (4.47–7.24) times risk compared with leukoplakia. The corresponding figures for erythroplakia, erythroleukoplakia, and OSF were 2.25 (1.31–3.89), 2.00 (1.13–3.53), and 1.63 (1.29–2.06), respectively. Alcohol drinking elevated the overall risk of malignant transformation by 23% (1–52% and also triggered a higher risk in OSF (aHR = 1.62 (1.06–2.47)). The higher risk attributed to betel quids chewing was noted for exophytic verrucous hyperplasia (aHR = 4.23 (1.55–11.55)). Conclusions: The risk of malignant transformation to oral cancer varied with the subtypes of OPMD and was elevated in OSF and verrucous hyperplasia attributed to alcohol drinking and betel quids, respectively.

AB - Objectives: To elucidate the risk of malignant transformation to invasive oral cancer by subtypes of oral potentially malignant disorders (OPMD) and to examine the independent effects of risk factors, particularly alcohol drinking, by subtype based on a nationwide oral cancer screening program targeting at general population with habits of smoking and/or betel quids chewing. Materials and methods: The total of 8501 subjects diagnosed as different subtypes of OPMDs from the Taiwanese screening program between 2004 and 2009 were followed up over time to ascertain the occurrence of invasive oral cancer. The hazard ratios of malignant transformation were estimated by using Cox proportional hazards regression model. Results: The overall malignant rate (per 1000 person-years) to oral cancer was 8.4 (407 incident cases with an average of 5.7 years of follow-up). The highest rate was noted in exophytic verrucous hyperplasia (33), followed by erythroplakia (11.8), erythroleukoplakia (10.7), oral submucous fibrosis (OSF) (8.6), and leukoplakia (5.4). After adjusting for confounders, exophytic verrucous hyperplasia still had a 5.69 (4.47–7.24) times risk compared with leukoplakia. The corresponding figures for erythroplakia, erythroleukoplakia, and OSF were 2.25 (1.31–3.89), 2.00 (1.13–3.53), and 1.63 (1.29–2.06), respectively. Alcohol drinking elevated the overall risk of malignant transformation by 23% (1–52% and also triggered a higher risk in OSF (aHR = 1.62 (1.06–2.47)). The higher risk attributed to betel quids chewing was noted for exophytic verrucous hyperplasia (aHR = 4.23 (1.55–11.55)). Conclusions: The risk of malignant transformation to oral cancer varied with the subtypes of OPMD and was elevated in OSF and verrucous hyperplasia attributed to alcohol drinking and betel quids, respectively.

KW - Malignant transformation

KW - Mass screening

KW - Oral cancer

KW - Oral potentially malignant disorder

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