Spectrum of premalignant oral lesions in rural North Indian population at a tertiary care hospital

Background: The objective of the study was to study the spectrum of premalignant oral lesions in rural North Indian population at a tertiary care hospital. Methods: A total of 340 patients with oral lesions for more than 2 weeks were enrolled in the study. Patients with proven malignancy, white patch in the oral cavity which can be scrapped off, e.g. oral candidiasis and urban patients were excluded. Biopsy specimen was obtained from all the patients and evaluated histopathologically. Site, nature and type of oral lesion were determined. Demographic data and exposure to different risk factors was also noted. Findings were correlated using Chi-square test. Results: Premalignant lesions were seen in 191 (56.18%) cases. They included leukoplakia (n=87; 45.5%), OSMF (n=62; 32.5%), Erythroplakia (n=18; 9.4%), lichen planus (n=15; 7.9%), melanoplakia/ melanosis (n=8; 4.2%) and DLE (n=1; 0.5%) respectively. Most common sites affected by premalignant lesions were buccal mucosa (n=173; 90.6%), retromolar area (n=42; 22%). Majority of patients with premalignant lesions were aged 26-50 years (78.5%), males (62.8%), farmers/labourers (56%) and illiterate/educated upto primary level (57.1%). Almost all the patients had two or more adverse oral habits with areca nut chewing being most common (69.6%) followed by tobacco chewing (66%) and smoking (60.2%) respectively. Majority had these addictions for >5 years (66%). Conclusions: Leukoplakia and OSMF dominated the premalignant lesions in rural patients having low education and high prevalence of adverse oral habits for prolonged duration.