Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Jul 20, 2022; 12(4): 293-304
Published online Jul 20, 2022. doi: 10.5662/wjm.v12.i4.293
Prevalence of precancerous lesions and conditions in India: A systematic review and meta-analysis
Abhishek Kumbhalwar, Sahana Hegde Shetiya, Pradnya Kakodkar, Vini Mehta, Ankita Mathur, Priyanka Porwal
Abhishek Kumbhalwar, Department of Public Health Dentistry, D.Y. Patil Dental School, Charholi, Lohegaon, Pune 412105, India
Sahana Hegde Shetiya, Vini Mehta, Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, India
Pradnya Kakodkar, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, India
Ankita Mathur, Priyanka Porwal, Public Health, STAT SENSE, Gandhinagar 382421, India
Author contributions: Kumbhalwar A, Shetiya SH, Kakodkar P, Mehta V, Mathur A and Porwal P contributed to acquisition of data, analysis and interpretation of data, drafting the article, making critical revisions related to important intellectual content of the manuscript, and final approval; Mehta V contributed to acquisition of data, analysis and interpretation of data, making critical revisions related to important intellectual content of the manuscript, and final approval; Shetiya SH contributed to conception and design of the study, acquisition of data, making critical revisions related to important intellectual content of the manuscript, and final approval; and All authors discussed the results and contributed to the final manuscript.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vini Mehta, MDS, Associate Professor, Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, India. vini.mehta@statsense.in
Received: February 16, 2022
Peer-review started: February 16, 2022
First decision: April 12, 2022
Revised: April 19, 2022
Accepted: July 8, 2022
Article in press: July 8, 2022
Published online: July 20, 2022
Processing time: 154 Days and 1.7 Hours
Abstract
BACKGROUND

Smoking and chewing tobacco are associated with numerous oral mucosal lesions and conditions, often leading to cancer progression.

AIM

To investigate the prevalence of precancerous lesions and conditions among the Indian population.

METHODS

Systematic search was conducted for population or community-based observational epidemiological studies in PubMed, EMBASE, Web of Science, IndMED, Google Scholar, reports of the WHO South-East Asia Region, MOHFW India reports, Science Citation Index, WHO Index Medicus of the South-East Asian Region, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Open Grey from the earliest available up to 31st January 2022. The effect size was calculated for the prevalence of precancerous lesions and conditions.

RESULTS

One hundred sixty-two estimates from 130 studies yielded 52 high, 71 moderate, and seven low-quality studies from 823845. Point estimate based on cross-sectional studies for leukoplakia was 4.3% (95%CI: 4.0-4.6), oral submucous fibrosis was 2.7% (95%CI: 2.5-3.0), palatal lesions in reverse smokers and nicotine palatine were 5.8% (95%CI: 4.4-7.2), and Erythroplakia was 1.2% (95%CI: 0.7-1.7), and lichen planus was 1.1% (95%CI: 0.9-1.2). Amongst hospital-based studies, the pooled prevalence for Leukoplakia was 6.7% (95%CI: 6.0-7.3), oral submucous fibrosis was 4.5% (95%CI: 4.2-4.9), lichen planus was 7.5% (95%CI: 5.3-9.6), and erythroplakia was 2.5% (95%CI: 0.4-4.5), and palatal lesions in reverse smokers and nicotine palatini were 11.5% (95%CI: 8.0-15.0).

CONCLUSION

Precancerous lesions and conditions are prevailing problems among the Indian population. It is mainly due to tobacco use, the smokeless form of tobacco. The meta-analysis indicates that hospital-based studies have a higher effect size of 6.7% than community-based studies. Patients who have already developed this condition may be advised to reduce their exposure to the risk factor to prevent the condition from progressing further.

Keywords: Prevalence; Pre-cancerous lesion; Pre-cancerous condition; India

Core Tip: World Health Organization assessment estimated that by 2020 tobacco-related death may exceed 1.5 million annually or 13% of all deaths in India. Tobacco consumption and smoking are seen in different socioeconomic groups, and this adverse habit is spread over urban and rural areas, giving rise to precancerous lesions and conditions. Prevalence of various oral lesions and conditions in India are varying in different studies. Numerous studies have been conducted throughout India to determine the prevalence of precancerous lesions and conditions.