Determinants of Oral Squamous Cell Carcinoma at the Maxillo-Facial Unit of the University Teaching Hospitals in Lusaka, Zambia

Abstract

Introduction: Oral Squamous Cell Carcinoma (OSCC) accounts for nearly 90% of all oral cancers. In resource-constrained settings, such as Zambia, most contributing factors to oral squamous cell carcinoma are unknown. Therefore, this study aimed to identify determinants of Oral Squamous Cell Carcinoma in patients presenting to the Maxillo-Facial Unit at the Adult University Teaching Hospital in Lusaka, Zambia. Methods: A cross-sectional study was conducted from June to December 2020. A systematic random sampling was used to identify 249 eligible participants from whom data was collected using a validated structured questionnaire. Determinants of Oral Squamous Cell Carcinoma were identified in a multivariable logistic regression analysis. Results: The prevalence of Oral Squamous Cell Carcinoma was 42.1% (95% CI: 36% - 48%). Grade II (moderately differentiated, n=68, 64%) histopathology subtype was the most prevalent. Determinants of Oral Squamous Cell Carcinoma were increasing age (AOR: 1.19, 95% CI: 1.08–1.32), being male (AOR: 2.04, 95% CI: 1.03–4.04), tobacco use (AOR: 3.49, 95% CI: 1.34–9.05), low BMI (AOR: 3.80, 95% CI: 1.52–9.52), and having the disease for more than six months (AOR: 2.21, 95% CI:1.06–4.60). Higher BMI (AOR: 0.48, 95% CI: 0.23-0.99) and poor oral hygiene (AOR: 0.35, 95% CI: 0.18-0.69) were associated with reduced risk. Conclusion: At the Maxillo-Facial Unit, 42.1% of suspected patients had Oral Squamous Cell Carcinoma. Tobacco prevention should be prioritised, as should promoting early health-seeking attitudes and health education, especially among males.