The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 17 , ISSUE 9 ( September, 2016 ) > List of Articles


Assessing the Risk of Oral Cancer associated with Gutka and Other Smokeless Tobacco Products: A Case–control Study

QA Hussain, Mahesh Maralingannavar

Citation Information : Hussain Q, Maralingannavar M. Assessing the Risk of Oral Cancer associated with Gutka and Other Smokeless Tobacco Products: A Case–control Study. J Contemp Dent Pract 2016; 17 (9):740-744.

DOI: 10.5005/jp-journals-10024-1922

Published Online: 01-01-2017

Copyright Statement:  Copyright © 2016; The Author(s).



Tobacco and tobacco-related products have been attributed to be causative factors for oral cancer. Newer, chewable, and commercially available smokeless tobacco (ST) products, such as gutka pose further threat in this direction. The aim of the study was to evaluate the risk of oral cancer associated with gutka and other ST products.

Materials and methods

A case-control study of 134 cases and 134 controls, over a period of 6 months (July–December 2014), was carried out at the Baqai University, Karachi, Pakistan. An interview-based questionnaire was used to collect data on sociodemographic characteristics, oral hygiene practices and type, duration, and frequency of use of tobacco-related products. Data were analyzed using the Pearson's chi-square (χ2) test with the level of significance set as p < 0.05.


Gutka showed the highest odds ratio toward developing oral cancer ratio among all the tobacco-related products [odds ratio (OR) 5.54; 95% CI 2.83–10.83; p < 0.001)]. Participants who consumed other ST products also showed 2 to 4 times higher odds ratio of developing oral cancer than compared to those who did not consume these products.


The study provided strong evidence that gutka and other ST products are independent risk factors for oral cancer.

Clinical significance

This study highlights the strong association of different types of ST and oral cancer. This results in identification of high-risk groups for targeted screening for potential oral cancer lesions.

How to cite this article

Awan KH, Hussain QA, Patil S, Maralingannavar M. Assessing the Risk of Oral Cancer associated with Gutka and Other Smokeless Tobacco Products: A Case-control Study. J Contemp Dent Pract 2016;17(9): 740-744.

PDF Share
  1. Cancer incidence in five continents. Vol. VIII. Lyon: IARC Scientific Publications No. 155, IARC Press; 2002.
  2. Early detection of oral cancer – guidelines for dental practitioners. J Int Oral Health 2016;8(3):399-403.
  3. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009 Apr-May;45(4-5):309-316.
  4. Patterns of disease and treatment and their implications for dental health services research. Community Dental Health 1993 Sep;10 Suppl 2:39-46.
  5. Oral Squamous cell cancer: early detection and the role of alcohol and smoking. Head Neck Oncol 2011 Jan 6;3:2.
  6. Epidemiology of cancer from the oral cavity and pharynx. Eur J Gastroenterol Hepatol 2011 Aug;23(8):633-641.
  7. IARC monographs on the evaluation of carcinogenic risks to humans. Betel-quid and areca-nut chewing and some areca-nut related nitrosamines. Vol. 85. IARC; Lyon, France, 2004.
  8. Smokeless tobacco and some tobacco-specific N-nitrosamines. Monographs. Vol. 89. Lyon: IARC; 2007.
  9. Effects of tobacco use on oral health – an overview. Annal Dent Univ Malaya 2011;18:18-23.
  10. Clinical, pathological, cellular and molecular lesions caused by oral smokeless tobacco – a review. J Oral Pathol Med 2007 Feb;36(2):63-77.
  11. Oral cavity cancer in developed and in developing countries: population-based incidence. Head Neck 2010 Mar;32(3):357-367.
  12. Report based on cancer cases registered at SKMCH&RC from 1994 Dec–2011 Dec and in 2011. Released 2012 Jun. Available from: .
  13. Paan without tobacco: an independent risk factor for oral cancer. Int J Cancer 2000 Apr 1;86(1):128-131.
  14. Addicted school children: prevalence and characteristics of areca nut chewing among primary school children in Karachi, Pakistan. J Paediatr Child Health 2002 Oct;38(5):507-510.
  15. Tobacco habit in Northern India. J Indian Med Assoc 2006 Jan;104(1):19-22, 24.
  16. Knowledge, attitude and practices of a Karachi slum population regarding the role of products of betel, areca and smokeless tobacco in the etiology of head and neck cancers. J Pak Med Assoc 2005:S41.
  17. Alert for an epidemic of oral cancer due to use of the betel quid substitutes gutka and pan masala: a review of agents and causative mechanisms. Mutagenesis 2004 Jul;19(4):251-262.
  18. The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan. Br J Cancer 2003 Feb 10;88(3):366-372.
  19. Effect of betel chewing, tobacco smoking and alcohol consumption on oral submucous fibrosis: a case control study in Sri Lanka. J Oral Pathol Med 2006 Apr;35(4):197-201.
  20. Risk for oral cancer associated to smoking, smokeless and oral dip products. Ind J Public Health 2012 Jan-Mar;56(1):57-60.
  21. The hazards of gutka chewing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010 Nov;110(5):548.
  22. Malignant transformation rate in oral submucous fibrosis over a 17-year period. Community Dent Oral Epidemiol 1985 Dec;13(6):340-341.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.