Alcohol drinking, body mass index and the risk of oral leukoplakia in an Indian population

Although tobacco habits have been associated with the risk of oral leukopla kia, alcohol drinking and body mass index (BMI) as risk factors have not be en well established. The purpose of this study is to evaluate the independe nt effects of drinking, BMI, tobacco chewing and smoking on the risk of ora l leukoplakia. A case-control study was conducted, with data from an ongoin g randomized oral cancer screening trial in Kerala, India. Trained health w orkers conducted interviews and performed oral visual inspections to identi fy oral premalignant lesions such as leukoplakia. The logistic regression m odel in SAS war used to estimate odds ratios (OR) and 95% confidence interv als (95% CI). A total of 927 leukoplakia cases and 47,773 controls were inc luded in the analysis. Ever alcohol drinking was a significant risk factor for oral leukoplakia among nonsmokers (OR = 2.1, 95%CI = 1.3, 3.4) and non- chewers (OR 1.8, 95%CI = 1.3, 2.5) after adjusting for age, sex, education, BMI and tobacco habits. The association with alcohol drinking was stronger among women (OR = 3.9, 95%CI = 1.5, 10.4) than men (OR = 1.5, 95%CI = 1.3, 1.9). An inverse dose-response 1relationship was observed between BMI and the risk of oral leukoplakia (p for trend = 0.0075). Tobacco chewing was a stronger risk factor for women (OR 37.7, 95%CI = 24.2, 58.7) than for men ( OR = 3.4, 95%CI = 2.8, 4.1). Smoking war a slightly stronger risk factor fo r men (OR 3.3, 95%CI = 2.5, 4.3) than for women (OR 2.0, 95%CI = 1.5, 2.9). In conclusion, alcohol drinking was found to be an independent risk factor while BMI might be inversely associated with the risk of oral leukoplakia in an Indian population. (C) 2000 Wiley-Liss, Inc.