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September 10, 2025Open Access

Prevalence of oral leukoplakia, erythroplakia, and oral submucous fibrosis in patients consuming tobacco and arecanut: a hospital-based observational study

Key Points

A total prevalence of 7.57% for oral potentially malignant disorders was observed among users of tobacco and areca nut.
Oral submucous fibrosis was the most common disorder at 5.30%, followed by leukoplakia at 2.22% and erythroplakia at 0.036%.
The study utilized a prospective observational design with ethical clearance from a tertiary care center in Central India.
The findings highlight the urgent need for public health interventions to address the high prevalence of oral cancers linked to tobacco use.

Abstract

Background In 2022, global oral squamous cell carcinoma (OSCC) incidence was 389,846 cases, with 188,438 deaths (GLOBOCAN). In India, it ranked 2nd with 143,759 cases and 79,979 deaths, and a 5-year prevalence of 370,106 cases. High OSCC rates are associated with oral leukoplakia, erythroplakia, and oral submucous fibrosis (OSMF), with malignant conversion rates of 1.1%-40.8% for leukoplakia, 19.9%-45% for erythroplakia, and 6% for OSMF. Central India has the highest oral cancer incidence, 19.2% in males and 7.6% in females. Limited research highlights the need for public health interventions; our study offers key epidemiological insights from a tertiary care center. Objective The study investigates the prevalence and epidemiology of oral leukoplakia, erythroplakia, and OSMF among tobacco and areca nut users. Material and methods This prospective observational study was conducted at the Govt Dental Institute, of Central India, from September 2022 to March 2023, with ethical clearance (No. 161/IEC/SS/2022). A purposive sampling approach targeted individuals with smokeless tobacco, smoking, or areca nut consumption. Oral cavity screenings were conducted, classifying leukoplakia, erythroplakia, and OSMF using established clinical criteria. The data were analyzed using SPSS 25.0, with significance set at p < 0.05. Results Among 28,736 patients, 5,428 had a history of tobacco or areca nut consumption, and 411 were diagnosed with OPMDs (Oral Potentially Malignant Disorders), yielding an overall prevalence of 7.57%. OSMF was the most common disorder (5.30%), followed by oral leukoplakia (2.22%) and erythroplakia (0.036%). The most prevalent habit was areca nut and smokeless tobacco consumption (71.53%). OSMF Grade IV had the highest prevalence (36.79%). Conclusions The prevalence of Oral Potentially Malignant Disorders in this study (7.57%) exceeds global averages, highlighting the impact of tobacco and areca nut consumption in Central India. OSMF, particularly Grade IV, is more prevalent, underscoring the need for targeted public health interventions and rigorous screening for early detection and management.

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