Clinical Presentation And Risk Factors Of Oral Squamous Cell Carcinoma Patients In Karachi, A Multicenter Cross-Sectional Study
DOI:
https://doi.org/10.63682/jns.v14i32S.9293Abstract
Background: Oral Squamous Cell Carcinoma (OSCC) is the most common malignancy of the oral cavity and ranks among the leading cancers in South Asia. Pakistan carries a high burden due to widespread use of smokeless tobacco, areca nut and delayed presentation.
Objectives: To evaluate the clinical presentation and associated risk factors of OSCC patients presenting at Darul Sehat Hospital, Jinnah Postgraduate Medical Centre (JPMC), and Dow International Dental College (DIDC), Karachi.
Methods: A multicenter cross-sectional study (January–June 2025) of histopathologically confirmed OSCC patients (N = 366). Demographic, exposure and clinical data were collected via structured questionnaire and record review. Data were analyzed with SPSS v22; descriptive statistics, chi-square tests, and multivariable logistic regression were applied; significance set at p < 0.05.
Results: Mean age was 52.4 ± 12.3 years; 71% were male. Most common sites were buccal mucosa (39.9%) and tongue (30.1%). Major risk factor were smokeless tobacco (63.4%), areca nut (52.7%), cigarette smoking (37.2%), and poor oral hygiene (69.4%). Late-stage presentation (III–IV) occurred in 68% of cases. Smokeless tobacco use was strongly associated with buccal mucosa lesions (p<0.001), cigarette smoking with tongue lesions (p=0.02), and low education with late-stage disease (p<0.001). Multivariable regression showed smokeless tobacco (aOR=1.9, p=0.01), areca nut (aOR=1.8, p=0.03), and low education (aOR=2.2, p=0.001) significantly predicted late-stage disease.
Conclusion: High prevalence of smokeless tobacco/areca nut use and frequent late-stage presentation highlight the need for targeted prevention and early-detection programs in Karachi
Downloads
References
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018 Nov;68(6):394-424. https://doi.org/10.3322/caac.21492
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021 May;71(3):209-49. https://doi.org/10.3322/caac.21660
Ali Z, et al. Epidemiology of oral cancer in Karachi, Pakistan. J Pak Med Assoc. 2022.DOI: https://doi.org/10.47391/JPMA.20599
Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral oncology. 2009 Apr 1;45(4-5):309-16.DOI: 10.1016/j.oraloncology.2008.06.002
Chaturvedi AK. Global burden of human papillomavirus-positive head and neck cancers. The Lancet Oncology. 2014 Nov 1;15(12):1282-3. DOI: 10.1016/S1470-2045(14)71029-0
IARC. Head and Neck Cancers, Cancer Incidence and Mortality Worldwide. International Agency for Research on Cancer. 2020. doi: 10.3322/caac.21660.
Anwar N, Pervez S, Chundriger Q, Awan S, Moatter T, Ali TS. Oral cancer: Clinicopathological features and associated risk factors in a high risk population presenting to a major tertiary care center in Pakistan. Plos one. 2020 Aug 6;15(8):e0236359. doi: 10.1371/journal.pone.0236359
Khan MF, Hayhoe RP, Kabir R. Exploring the risk factors for oral Cancer in Pakistan: a systematic literature review. Dentistry Journal. 2024 Jan 29;12(2):25. doi: 10.3390/dj12020025.
Shamsi U, Khan MA, Qadir MS, Rehman SS, Azam I, Idress R. Factors associated with the survival of oral cavity cancer patients: a single institution experience from Karachi, Pakistan. BMC Oral Health. 2024 Nov 22;24(1):1427. DOI:https://doi.org/10.1186/s12903-024-04920-4
Wikipedia contributors. Oral cancer. Wikipedia, The Free Encyclopedia. Updated 2025. https://en.wikipedia.org/wiki/Oral_cancer
Anwar N, Pervez S, Chundriger Q, Awan S, Moatter T, Ali TS. Oral cancer: Clinicopathological features and associated risk factors in a high risk population presenting to a major tertiary care center in Pakistan. Plos one. 2020 Aug 6;15(8):e0236359. doi: 10.1371/journal.pone.0236359.
Dogar MR, Waheed A, Ullah I, Khan H, Mahar GS, Anwar Z. Frequency, Clinical Presentation and Risk Factors of Carcinoma of Cheek in Patients Presenting at JPMC Karachi. Journal of the Dow University of Health Sciences (JDUHS). 2022 Apr 20;16(1):17-21.https://doi.org/10.36570/jduhs.2022.1.1237J
Ahmed HW, Rais A, Kafait M, Quirk AM, Warraich RA. The Silent Epidemic: Ten-Year Clinical Patterns of Oral Squamous Cell Carcinoma in Pakistan (2015–2025). The Critical Review of Social Sciences Studies. 2025 Aug 1;3(3):1046-55. DOI: https://doi.org/10.59075/1gz07k82
Usman S, Ahmed S, Iqbal S, Kashif M, Khan S. Clinical Presentation, Tumour Characteristics, Sociodemographic, and Lifestyle-Related Factors of Oral Cancer in Patients Visiting Abbasi Shaheed Hospital, Karachi Pakistan. Pakistan Armed Forces Medical Journal. 2024 Apr 30;74(2):405. DOI: https://doi.org/10.51253/pafmj.v74i2.8172
Hashmi AA, Mudassir G, Rashid K, Malik UA, Zia S, Zia F, Irfan M. Risk factors of oral squamous cell carcinoma with special emphasis on Areca Nut Usage and Its Association with clinicopathological parameters and recurrence. International Journal of Surgical Oncology. 2024;2024(1):9725822. doi: 10.1155/2024/9725822
Memon MA, Ahmed KA, Shaikh AH. Reasons for delayed presentation in patients of oral squamous cell carcinoma: a prospective study. PJMHS. 2020;14:1536-9.
Shamsi U, Arshad MS, Rashid YA, Jehanzeb H, Pasha HA. Determinants of oral cavity cancer recurrence in Pakistan: findings from a cross-sectional study using an institutional cancer registry. BMC cancer. 2025 Mar 13;25(1):459. DOI:https://doi.org/10.1186/s12885-025-13443-2
Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version 3.01, updated 2013.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Maryam Abid, Atiqa Zahid, Vishal Kumar, Anchal Bai, Aimen Abubakar, Anum Altaf
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
